RISKS OF INTRAABDOMINAL NONSHUNT SURGERY IN CIRRHOTICS

We have reviewed the risks of various nonshunt intra-abdominal operati ons in cirrhotic patients. Most of these studies are retrospective rev iews with limitations. Among various risk stratifications in cirrhosis , Child-Pugh classification is sufficiently informative. Elective surg ery can be done safely in patients with Child's A or B class. Operatio ns in Child's C patients and emergent surgery carry formidably high mo rtality. Limiting the extent of surgery, controlling ascites, correcti ng coagulation abnormality and malnutrition and aggressively treating infection, might reduce mortality. Laparoscopic cholecystectomy and en doscopic sphincterotomy in cirrhotics seem to be promising in reducing mortality and morbidity.