Hernia repair in patients with chronic liver disease - A 15-year single-center experience

Clayton C. Petro, Ivy N. Haskins, Arielle J. Perez, Luciano Tastaldi, Andrew T. Strong, Ramona N. Ilie, Chao Tu, David M. Krpata, Ajita S. Prabhu, Bijan Eghtesad, Michael J. Rosen

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: Elective hernia repairs in chronic liver disease (CLD) patients are often avoided due to the fear of hepatic decompensation and mortality, leaving the patient susceptible to an emergent presentation. Methods: CLD patients undergoing ventral or inguinal hernia repair in emergent and non-emergent settings at our institution (2001–2015) were analyzed. Predictors of 30-day morbidity and mortality (M&M) were determined using univariate analysis and multivariate logistic regression. Results: A total of 186 non-emergent repairs identified acceptable rates of M&M (27%) and 90-day mortality (3.7%, 0/21 for MELD≥15). Meanwhile, 67 emergent repairs had higher rates of M&M (60%) and 90-day mortality (10%; 25% for MELD≥15). M&M was associated with elevated MELD scores in emergent cases (14 ± 6 vs 11 ± 4; p = 0.01) and intraoperative drain placement in non-emergent cases (OR1.31,p < 0.01). Conclusion: In patients with advanced CLD, non-emergent hernia repairs carry acceptable rates of M&M, while emergent repairs have increased M&M rates associated with higher MELD scores. A large single-center cohort suggests that patients with advanced liver disease have acceptable outcomes after hernia repair in an elective setting compared to their emergent counterparts.

Original languageEnglish (US)
Pages (from-to)59-65
Number of pages7
JournalAmerican journal of surgery
Volume217
Issue number1
DOIs
StatePublished - Jan 2019
Externally publishedYes

Keywords

  • Cirrhotic
  • Hernia
  • Incisional
  • Inguinal
  • Ventral

ASJC Scopus subject areas

  • Surgery

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