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Evaluation of hernia repair operation in Child-Turcotte-Pugh class C cirrhosis and refractory ascites

Cited 19 time in Web of Science Cited 23 time in Scopus
Authors
Park, Joo Kyung; Lee, Sang Hyub; Yoon, Won Jae; Lee, Jun Kyu; Park, Su Cheol; Park, Bum Joon; Jung, Yong Jin; Kim, Byeong Gwan; Yoon, Jung-Hwan; Kim, Chung Yong; Ha, Jongwon; Park, Kyu Joo; Kim, Yoon Jun
Issue Date
2007
Publisher
Blackwell Publishing
Citation
J. Gastroenterol. Hepatol. 2007; 22: 377-82
Keywords
Child–Turcotte–Pugh (CTP) classcirrhosishernia repair surgeryherniarefractory ascites
Abstract
BACKGROUND AND AIM: Abdominal wall hernia is a common feature of decompensated liver cirrhosis and frequently causes life-threatening complications or severe pain. However, there have been no data reported on postoperative mortality, hepatic functional deterioration and recurrence rate according to Child-Turcotte-Pugh (CTP) class and to the presence of refractory ascites. METHODS: The study population comprised 53 liver cirrhosis patients who underwent hernia repair operation. Comparisons were made of 30-day mortality among the different CTP classes, and between those with or without refractory ascites. Liver function was also analyzed just before the operation, in the immediate postoperative period, and in the remote postoperative period. RESULTS: Seventeen patients were in CTP class A, 27 patients in class B, and 9 patients in class C. The median follow-up duration was 24 months. There was single 30-day postoperative mortality in class C, and no CTP class deterioration after 30 days of operation. There was no mortality or recurrences in 17 patients with medically refractory ascites. The difference in 30-day mortality according to CTP class and the presence of refractory ascites did not show statistical significance (P = 0.17 and 0.97, respectively). CONCLUSION: Hernia operation could be done safely in CTP class A and B with low rate of recurrences, and there was no definitive increase in the operative risk in class C. In addition, refractory ascites did not increase operative risk and recurrence rate. Therefore, surgical repair might be recommended even in patients with refractory ascites and poor hepatic function to prevent life-threatening complications or severe pain.
ISSN
0815-9319 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17295770

http://hdl.handle.net/10371/11017
DOI
https://doi.org/10.1111/j.1440-1746.2006.04458.x
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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