OUTCOME OF BILIARY-TRACT SURGERY IN UNKNOWN CIRRHOTICS - A CASE-CONTROL STUDY

The substantial risk of biliary surgery in patients with liver cirrhos is may be reduced by preoperative preparation but the problem of the u nknown cirrhotic remains. We studied 18 patients found incidentally to have cirrhosis at surgery. The perioperative complications and the ou tcome in these patients was compared with 18 non-cirrhotic patients, c omputer matched for age and sex, undergoing the same operations. Mean blood loss at operation was 324 ml (SD 218.1 ml) in the cirrhotic grou p and 105 ml (SD 74.7 ml) in the control group (P < 0.01). The postope rative complication rate was 38% in cirrhotics, but zero in controls ( P < 0.01). The length of hospital stay was significantly increased in the cirrhotic group (P < 0.01). There was no mortality in either group . The incidental finding of cirrhosis at biliary surgery is associated with increased peroperative bleeding and increased morbidity. There i s no increase in mortality in such patients.