Skip to main content
Erschienen in: Gastro-News 5/2020

21.10.2020 | Leberzirrhose | Fortbildung

Hepatologie - Teil 5: Leberzirrhose

Viszerale Operationen bei Patienten mit Leberzirrhose - was ist zu beachten?

verfasst von: Samira Ben Brahim, PD Dr. med. Daniel Hartmann, PD Dr. med. Michael W. Müller, Prof. Dr. med. Helmut Friess

Erschienen in: Gastro-News | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Auszug

Patienten mit Leberzirrhose haben ein erhöhtes perioperatives Komplikationsrisiko mit deutlich erhöhter Morbidität sowie Mortalität. Eine präoperative Optimierung des Allgemein- und Funktionszustandes ist nach erfolgter Risikostratifizierung vor Operationen essenziell. Wichtig bleibt, dass zirrhotische Patienten als solche erkannt werden und die Dringlichkeit des Eingriffs im Rahmen einer sorgfältigen Operationsindikationsstellung festgelegt wird. …
Literatur
1.
Zurück zum Zitat Abbas N , Makker J, Abbas H, Balar B. Perioperative care of patients with liver cirrhosis: a review Health Services Insight 2017:G1-G12 Abbas N , Makker J, Abbas H, Balar B. Perioperative care of patients with liver cirrhosis: a review Health Services Insight 2017:G1-G12
2.
Zurück zum Zitat Stasi C, Silvestri C, Voller F, Cipriani F. Epidemiology of liver cirrhosis Journal of Clinical and Experimental Hepatology 2015;5(3):272 Stasi C, Silvestri C, Voller F, Cipriani F. Epidemiology of liver cirrhosis Journal of Clinical and Experimental Hepatology 2015;5(3):272
3.
Zurück zum Zitat Kays JK, Milgrom DP, Butler JR, Liang TW, Valsangkar NP, Wojcik B et al. Specialised care improves outcomes for patients with cirrhosis who require general surgical operations PLos ONE 2019;14(10):e0223454 Kays JK, Milgrom DP, Butler JR, Liang TW, Valsangkar NP, Wojcik B et al. Specialised care improves outcomes for patients with cirrhosis who require general surgical operations PLos ONE 2019;14(10):e0223454
4.
Zurück zum Zitat Patel T. Surgery in the patient with liver disease Mayo Clin Proc1999;74:593 Patel T. Surgery in the patient with liver disease Mayo Clin Proc1999;74:593
5.
Zurück zum Zitat Jarnagin WR,Gonen M,Fong Y et al.:Improvement in perioperative outcome after hepatic resection:analysis of 1,803 consecutive cases over the past decade. Ann Surg 2002;236:397-406 Jarnagin WR,Gonen M,Fong Y et al.:Improvement in perioperative outcome after hepatic resection:analysis of 1,803 consecutive cases over the past decade. Ann Surg 2002;236:397-406
6.
Zurück zum Zitat Kelly E. Diaz, Thomas D. Sciano et al. Current Gastroenterology Reports; 2019;21-32 Kelly E. Diaz, Thomas D. Sciano et al. Current Gastroenterology Reports; 2019;21-32
7.
Zurück zum Zitat Younossi ZM et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assesement of prelevance, incidence and outcomes. Hepatol 2016;64(1):73 Younossi ZM et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assesement of prelevance, incidence and outcomes. Hepatol 2016;64(1):73
8.
Zurück zum Zitat Wiegand J. Berg T. Ätiologie, Diagnose und Prävention einer Leberzirrhose Dtsch Arztebl Int 2013;110(6):85-91 Wiegand J. Berg T. Ätiologie, Diagnose und Prävention einer Leberzirrhose Dtsch Arztebl Int 2013;110(6):85-91
9.
Zurück zum Zitat Meringer H, Shibolet O, Deutsch L. Hepatucellular carcinoma in the post-hepatitis C virus era: Should we change the paradigm? World J Gastroenterol 2019;25(29);3929-40 Meringer H, Shibolet O, Deutsch L. Hepatucellular carcinoma in the post-hepatitis C virus era: Should we change the paradigm? World J Gastroenterol 2019;25(29);3929-40
10.
Zurück zum Zitat Leven AS et al. Clinical presentation and long-term consequences of non-alcoholic fatty liver disease (NAFLD) in Adipositas - Ursachen, Folgeerkrankungen. Therapie 2017;11(01):4-8 Leven AS et al. Clinical presentation and long-term consequences of non-alcoholic fatty liver disease (NAFLD) in Adipositas - Ursachen, Folgeerkrankungen. Therapie 2017;11(01):4-8
11.
Zurück zum Zitat Montomoli J, Erichsen R, Christiansen CF et al. Liver disease and 30 day mortality after colorectal surgery : a Danish populationbased cohort study. BMC Gastroenterol 2013;13:66 Montomoli J, Erichsen R, Christiansen CF et al. Liver disease and 30 day mortality after colorectal surgery : a Danish populationbased cohort study. BMC Gastroenterol 2013;13:66
12.
Zurück zum Zitat Schemel WH. Unexpected hepatic dysfunction found by multiple labaratory screening Anaesth Analg 1976;55:810-16 Schemel WH. Unexpected hepatic dysfunction found by multiple labaratory screening Anaesth Analg 1976;55:810-16
13.
Zurück zum Zitat Child CG, Turcotte JG. Surgery and portal hypertension. In: The liver and portal hypertension. Edited by CG Child. Philadelphia: Saunders 1964:50-64 Child CG, Turcotte JG. Surgery and portal hypertension. In: The liver and portal hypertension. Edited by CG Child. Philadelphia: Saunders 1964:50-64
14.
Zurück zum Zitat Pugh RNH, Lyon-Murray IM, Dawson JL, Pietroni and Williams R. Transection oft he oesophagus for bleeding oesophageal varices. Brit J Surg 1973;60:646-9 Pugh RNH, Lyon-Murray IM, Dawson JL, Pietroni and Williams R. Transection oft he oesophagus for bleeding oesophageal varices. Brit J Surg 1973;60:646-9
15.
Zurück zum Zitat Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001;33:464-70 Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001;33:464-70
16.
Zurück zum Zitat Hickmann L et al. Journal of Gastrointestinal Surgery 2019;23:634-42 Hickmann L et al. Journal of Gastrointestinal Surgery 2019;23:634-42
17.
Zurück zum Zitat Müller C. Operationsrisiko bei chronischen Lebererkrankungen. J Gastroenterol Hepatol Erkr 2019;17:18-24 Müller C. Operationsrisiko bei chronischen Lebererkrankungen. J Gastroenterol Hepatol Erkr 2019;17:18-24
18.
Zurück zum Zitat Papastergiou V, Burroughs A K, Tsochatzis EA. Prognosis and treatment of patients with acute alcoholic hepatitis Expert Rev Gastroenterol Hepatol 2014;8:471-86 Papastergiou V, Burroughs A K, Tsochatzis EA. Prognosis and treatment of patients with acute alcoholic hepatitis Expert Rev Gastroenterol Hepatol 2014;8:471-86
19.
Zurück zum Zitat Mansour A, Watson W, Shayani V, Pickleman J. Abdominal operations in patients with cirrhosis: still a major surgical challenge. Surgery 1997;122:730-5 Mansour A, Watson W, Shayani V, Pickleman J. Abdominal operations in patients with cirrhosis: still a major surgical challenge. Surgery 1997;122:730-5
20.
Zurück zum Zitat Yeh CN,Chen MF, Jan YY. Laparoscopic cholecystectomy in 226 cirrhotic patients.Experience of a single center in Taiwan. Surg Endosc 2002;16:1583-7 Yeh CN,Chen MF, Jan YY. Laparoscopic cholecystectomy in 226 cirrhotic patients.Experience of a single center in Taiwan. Surg Endosc 2002;16:1583-7
21.
Zurück zum Zitat Kelly E. Diaz et al. Current Gastroenterology Reports 2019;21:32 Kelly E. Diaz et al. Current Gastroenterology Reports 2019;21:32
22.
Zurück zum Zitat Farnsworth N, Fagan SP, Berger DH, Awad SS. Child-Turcotte-Pugh versus MELD score as a predictor of outcome after elective and emergent surgery in cirrhotic patients. Am J Surg 2004;188:580-3 Farnsworth N, Fagan SP, Berger DH, Awad SS. Child-Turcotte-Pugh versus MELD score as a predictor of outcome after elective and emergent surgery in cirrhotic patients. Am J Surg 2004;188:580-3
23.
Zurück zum Zitat Eker HH, van Ramshorst GH, de Goede B, Tilanus HW, Metselaar HJ, de Man RA et al. A prospective study on elective umbilical hernia repair in patients with liver cirrhosis and ascites. Surgery 2011;150(3):542-6 Eker HH, van Ramshorst GH, de Goede B, Tilanus HW, Metselaar HJ, de Man RA et al. A prospective study on elective umbilical hernia repair in patients with liver cirrhosis and ascites. Surgery 2011;150(3):542-6
24.
Zurück zum Zitat Afdhal N, McHutchison J, Brown R, Jacobson I, Manns M, Poordad F et al. Thrombocytopenia associated with chronic liver disease. J Hepatol 2008;48(6):1000-7 Afdhal N, McHutchison J, Brown R, Jacobson I, Manns M, Poordad F et al. Thrombocytopenia associated with chronic liver disease. J Hepatol 2008;48(6):1000-7
25.
Zurück zum Zitat Samama CM, Djoudi R, Lecompte T, Nathan N, Schved JF. French health Products Safety AgencyExpert group. Perioperative platelet transfusion. Recommendations of the French health products Agency Minerva Anestesiol 2006;72:447-52 Samama CM, Djoudi R, Lecompte T, Nathan N, Schved JF. French health Products Safety AgencyExpert group. Perioperative platelet transfusion. Recommendations of the French health products Agency Minerva Anestesiol 2006;72:447-52
26.
Zurück zum Zitat De Pietri L, Bianchini M, Montalti R, De Maria N, De Maria T, Begliomini B, Gerunda GE, di Benedetto F, Garcia-Tsao G, Villa E. Thromboelastography-guided blood product use before invasive procedures in cirrhosis with severe coagulopathy: A randomized, controlled trial. Hepatology 2016;63:566-73 De Pietri L, Bianchini M, Montalti R, De Maria N, De Maria T, Begliomini B, Gerunda GE, di Benedetto F, Garcia-Tsao G, Villa E. Thromboelastography-guided blood product use before invasive procedures in cirrhosis with severe coagulopathy: A randomized, controlled trial. Hepatology 2016;63:566-73
27.
Zurück zum Zitat Tripodi A, Prigmani M et al. Detection oft he imbalance of procoagulant versus anticoagulant factors in cirrhosis by a simple labaratory method. Hepatology 2010;52:249-55 Tripodi A, Prigmani M et al. Detection oft he imbalance of procoagulant versus anticoagulant factors in cirrhosis by a simple labaratory method. Hepatology 2010;52:249-55
28.
Zurück zum Zitat Shah NL et al. Procoagulant therapeutics in liver disease. A critique and clinical rationale. Nat Rev Gastroenterol Hepatol 2014;11:675-82 Shah NL et al. Procoagulant therapeutics in liver disease. A critique and clinical rationale. Nat Rev Gastroenterol Hepatol 2014;11:675-82
29.
Zurück zum Zitat Eghtesad S, Poustchi H, Malekzadeh R. Malnutrition in liver cirrhosis: the influence of protein and sodium. Middle East J Dig Dis 2013;5:65-75 Eghtesad S, Poustchi H, Malekzadeh R. Malnutrition in liver cirrhosis: the influence of protein and sodium. Middle East J Dig Dis 2013;5:65-75
30.
Zurück zum Zitat Lai CC, You JF, Yeh CY, Chen JS, Tang R, Wang JY, Chin CC. Low preoperative serum albumin in colon cancer: a risk factor for poor outcome. Int J Colorectal Dis 2011;26:473-81 Lai CC, You JF, Yeh CY, Chen JS, Tang R, Wang JY, Chin CC. Low preoperative serum albumin in colon cancer: a risk factor for poor outcome. Int J Colorectal Dis 2011;26:473-81
31.
Zurück zum Zitat Burden S, Todd C, Hill J, Lal S. Pre-operative nutrition support in patients undergoing gastrointestinal surgery. Cochrane Database Syst Rev. 2012;11:CD008879 Burden S, Todd C, Hill J, Lal S. Pre-operative nutrition support in patients undergoing gastrointestinal surgery. Cochrane Database Syst Rev. 2012;11:CD008879
32.
Zurück zum Zitat Abid S, Ali S, Baig MA, Waheed AA. Is it time to replace propranolol with carvedilol for portal hypertension? World J Gastrointest Endosc 2015;7:532-9 Abid S, Ali S, Baig MA, Waheed AA. Is it time to replace propranolol with carvedilol for portal hypertension? World J Gastrointest Endosc 2015;7:532-9
33.
Zurück zum Zitat Friedman LS. Surgery in the patient with liver disease. Trans Am Clin Climatol Assoc 2010;121:192-204; discussion 205 Friedman LS. Surgery in the patient with liver disease. Trans Am Clin Climatol Assoc 2010;121:192-204; discussion 205
34.
Zurück zum Zitat Vinet E, Perreault P, Bouchard L, Bernard D, Wassef R, Richard C, Létourneau R, Pomier-Layrargues G. Transjugular intrahepatic portosystemic shunt before abdominal surgery in cirrhotic patients: a retrospective, comparative study. Can J Gastroenterol 2006;20:401-04 Vinet E, Perreault P, Bouchard L, Bernard D, Wassef R, Richard C, Létourneau R, Pomier-Layrargues G. Transjugular intrahepatic portosystemic shunt before abdominal surgery in cirrhotic patients: a retrospective, comparative study. Can J Gastroenterol 2006;20:401-04
35.
Zurück zum Zitat Bessa SS, Abdel-Razek AH, Sharaan MA et al. Laparoscopic cholecystectomy in cirrhotics: a prospective randomized study comparing the conventional diathermy and the harmonic scalpel for gallbladder dissection. J Laparoendosc Adv Surg Tech A 2011;21:1-5 Bessa SS, Abdel-Razek AH, Sharaan MA et al. Laparoscopic cholecystectomy in cirrhotics: a prospective randomized study comparing the conventional diathermy and the harmonic scalpel for gallbladder dissection. J Laparoendosc Adv Surg Tech A 2011;21:1-5
36.
Zurück zum Zitat Lopez-Delgado et al. Cirrhosis influence in non-hepatic surgery, World Journal of Gastroenterology 2016 March7;22(9):2657-67 Lopez-Delgado et al. Cirrhosis influence in non-hepatic surgery, World Journal of Gastroenterology 2016 March7;22(9):2657-67
37.
Zurück zum Zitat Telem et al. Complicated hernia presentation in patients with advanced cirrhosis and refractory ascites: management and outcome. Surgery 2010;148(3):538-43 Telem et al. Complicated hernia presentation in patients with advanced cirrhosis and refractory ascites: management and outcome. Surgery 2010;148(3):538-43
38.
Zurück zum Zitat Clark JR, Wills VL, Hunt DR. Cirrhosis and laparascopic cholecystectomy Surg Laparosc Endosc Percutan tech 2001;11:165-9 Clark JR, Wills VL, Hunt DR. Cirrhosis and laparascopic cholecystectomy Surg Laparosc Endosc Percutan tech 2001;11:165-9
39.
Zurück zum Zitat Cobb WS, Heniford BT, Burns JM et al. Cirrhosis is not a contraindication to laparoscopic surgery. Surg Endosc 2005;19:418-23 Cobb WS, Heniford BT, Burns JM et al. Cirrhosis is not a contraindication to laparoscopic surgery. Surg Endosc 2005;19:418-23
40.
Zurück zum Zitat Kandil T, El Nakeeb A, El Hefnawy E. Comparative study between clipless laparoscopic cholecystectomy by harmonic scalpel versus conventional method: a prospective randomized study. J Gastrointest Surg 2010;14:323-8 Kandil T, El Nakeeb A, El Hefnawy E. Comparative study between clipless laparoscopic cholecystectomy by harmonic scalpel versus conventional method: a prospective randomized study. J Gastrointest Surg 2010;14:323-8
41.
Zurück zum Zitat McAlister V. Management of umbilical hernia in patients with advanced liver disease. Liver Transpl 2003;9:623-5 McAlister V. Management of umbilical hernia in patients with advanced liver disease. Liver Transpl 2003;9:623-5
42.
Zurück zum Zitat Carbonell AM et al. Poor outcomes in cirrhosis-associated hernia repair: a nationwide cohort study of 32,033 patients. Hernia 2005;9:353-7 Carbonell AM et al. Poor outcomes in cirrhosis-associated hernia repair: a nationwide cohort study of 32,033 patients. Hernia 2005;9:353-7
43.
Zurück zum Zitat Amanda Nicoll et al. Surgical risk in patients with cirrhosis Journal of Gastroenterology and Hepatology 2012;1569-75 Amanda Nicoll et al. Surgical risk in patients with cirrhosis Journal of Gastroenterology and Hepatology 2012;1569-75
44.
Zurück zum Zitat Runyon BA. Management of adult patients with ascites due to cirrhosis Hepatology 2004;39:841-56 Runyon BA. Management of adult patients with ascites due to cirrhosis Hepatology 2004;39:841-56
45.
Zurück zum Zitat Macintyre PE, Scott DA, Schug SA, Visser EJ, Walker SM et al. Acute Pain Managmenet: Scientific Evidence Melbourne, Australian and New Zealand College of Anaesthetists 2010;3rd edn Macintyre PE, Scott DA, Schug SA, Visser EJ, Walker SM et al. Acute Pain Managmenet: Scientific Evidence Melbourne, Australian and New Zealand College of Anaesthetists 2010;3rd edn
46.
Zurück zum Zitat Friedman LS. The risk of surgery in patients with liver disease. Hepatology 1999;29:1617-23 Friedman LS. The risk of surgery in patients with liver disease. Hepatology 1999;29:1617-23
47.
Zurück zum Zitat Macintyre PE et al. Acute Pain Managmenet: Scientific Evidence Melbourne, Australian and New Zealand College of Anaesthetists 2010;3rd edn Macintyre PE et al. Acute Pain Managmenet: Scientific Evidence Melbourne, Australian and New Zealand College of Anaesthetists 2010;3rd edn
48.
Zurück zum Zitat Chatzizacharias NA et al. Successful surgical management of ruptured umbilical hernias in cirrhotic patients. World J Gastroenterol 2015;21:3109-13 Chatzizacharias NA et al. Successful surgical management of ruptured umbilical hernias in cirrhotic patients. World J Gastroenterol 2015;21:3109-13
Metadaten
Titel
Hepatologie - Teil 5: Leberzirrhose
Viszerale Operationen bei Patienten mit Leberzirrhose - was ist zu beachten?
verfasst von
Samira Ben Brahim
PD Dr. med. Daniel Hartmann
PD Dr. med. Michael W. Müller
Prof. Dr. med. Helmut Friess
Publikationsdatum
21.10.2020
Verlag
Springer Medizin
Erschienen in
Gastro-News / Ausgabe 5/2020
Print ISSN: 1869-1005
Elektronische ISSN: 2520-8667
DOI
https://doi.org/10.1007/s15036-020-1371-0

Weitere Artikel der Ausgabe 5/2020

Gastro-News 5/2020 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.