HERNIA REPAIR IN PATIENTS WITH CHRONIC LIVER DISEASE
Hernia Repair in Chronic Liver Disease
Objective: To investigate the safety of hernia repair operation by quantifying the postoperative mortality, postoperative hepatic functional deterioration, and early wound complication among patients in different Child– Turcotte–Pugh (CTP) class groups.
Study Design: Retrospective study.
Place and Duration of Study: CMH Multan from July 2013 to July 2015.
Material and Methods: This is a retrospective review of 277 patients with documented liver cirrhosis who underwent hernia repair (including inguinal, para-umblical and ventral wall hernia) at the combined Military Hospital Multan between July 2013 and July 2015. Morbidity and mortality was compared in three sub-groups based on Child’s classification.
Results: The present study consisted of 219 males and 58 females with an average age of 46.18±12.76. Mean child score was 7.66 (125, 101 and 51 patients in CTP Class A, B and C respectively). Of the present cohort, 173 patients required inguinal hernia repair with a mean Child score was 7.52 (92, 53 and 28 patients in CTP Class A, B and C respectively). Para-umblical hernia repair was done in 68 patients with a mean Child score of 7.84 (20, 31 and 17 patients in CTP Class A, B and C respectively). Thirty six patients were operated for ventral wall hernias. Their mean Child score was 7.99 (13, 17, 6 patients in CTP Class A, B and C respectively). In the 30 day post-operative period, two patients in CTP class A changed to class B. One patient in CTP class B progressed to class C. Complications occurred in 37 patients (13.36%) but all of these complications resolved by conservative management. Three patients died during the 30-day postoperative period.
Conclusion: We conclude that hernia repair in cirrhotic patients is not associated with an increased risk of postoperative complications and recommend elective surgery.