Editorial
Copyright ©2012 Baishideng Publishing Group Co.
World J Gastrointest Surg. Dec 27, 2012; 4(12): 267-274
Published online Dec 27, 2012. doi: 10.4240/wjgs.v4.i12.267
Table 1 Child-turcotte-pugh scoring system
VariablesPoints
123
Encephalopathy gradeNone1 and 23 and 4
AscitesAbsentControlledRefractory
Bilirubin (mg/dL)1.51.5-2.0> 2.0
Albumin (gm/dL)3.52.0-3.5< 2.0
Prothrombin time1-44-6> 6
Table 2 Preoperative variables and mortality rates of survivors and non-survivors of abdominal surgery
Preoperative variablesPercent of mortality if factors presentPercent of mortality if factors absent
Child class
A10
B31
C76
Ascites5811
Emergency surgery5710
Bilirubin > 3 mg/dL6217
Albumin < 3 mg/dL5812
Prothrombin time > 1.5 s above control6318
White blood cell count > 10 0005419
P < 0.01 for all variables
Table 3 Preoperative variable associated with mortality
Preoperative variableMortality in percent if present
Pulmonary failure100
Cardiac failure92
Requirement of > 2 antibiotics82
Renal failure73
Hepatic failure66
Gastrointestinal bleeding86
Required second operation81
Positive cultures61
Blood requirement > 2 units69
Blood requirement < 2 units22
Table 4 Factors predictive of perioperative complications and of postoperative mortality
Predictor of complicationsPredictor of mortality
Child-pugh class B and CMale gender
AscitesChild-Pugh class B and C
Etiology of cirrhosis other than primary biliary cirrhosisEtiology of cirrhosis other than primary biliary cirrhosis
Elevated creatinineAscites
Preoperative infectionPreoperative infection
Chronic obstructive pulmonary diseaseRespiratory surgery
Preoperative upper gastrointestinal bleedAmerican Society of Anaesthesiologists physical status IV and V
Invasiveness of surgical procedure
Intraoperative hypotension (20% decrease of base line blood pressure for 10 min or more)
American Society of Anaesthesiologists physical status IV and V
Table 5 Mortality rates in patients undergone cholecystectomy with or without cirrhosis
VariablesMortality
Patients with normal liver function1%
Patients with cirrhosis (PT < 2.5 s than control)9%
Patient with cirrhosis (PT > 2.5 s than control)83%