Slovenská chirurgia 3/2015
Patients with liver cirrhosis and elective surgical procedure
Patients with liver cirrhosis often undergo invasive elective procedure. Risk of decompensation liver cirhosis increase by any elective surgery under general anaesthesia carries. To indicate the patient is used risk stratification (scoring criteria). The choice of surgical technique and optimal anaesthesia, management of abnormalities of haemostasis are modified risk factors. The development of the liver cirhosis arise unstable equilibrium, fluid-coagulopathy balance. The patient is then after a little insult subject to the risk of bleeding as well as thrombosis. The aim of this work is to highlight the major changes in the perioperative management of patients with liver cirhosis undergoing operation with high degrease of invasivity. Identify risk group patients with liver cirhosis and using of personalized thromboelastometry (TEM) guided therapy has the main influence of incidence perioperative bleeding and thrombotic complications. Using TEM guided therapy of high risk patients with ESLD is more effective tool to decrease perioperative morbidity and mortality.
Keywords: liver cirrhosis, surgery, thromboelastometry, bleeding, thrombosis.
