HERNIA REPAIR IN PATIENTS WITH 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. [ABSTRACT FROM AUTHOR]