The Effect of General Anesthesia on Liver Function Tests in Patients with Portal Hypertension

Abstract

Abstract Background Patients with liver disease and portal hypertension usually as a result of advanced fibrosis or cirrhosis, are at increased risk of complications when undergoing surgery. Aim of the Work The aim of the study is to assess the changes in liver functions postoperatively in patients with portal hypertension undergoing abdominal or pelvic surgeries, to assess intra operative complications in patients with portal hypertension undergoing general anesthesia, for abdominal or pelvic surgeries. Patients and Methods The type of this study is prospective Observational Study, conducted at Ain Shams University Specialized Hospital on 40 patients in 6 months duration. Results In this study, we compared changes in liver functions postoperative in patients with portal hypertension undergoing pelvic surgery or abdominal surgery and there were highly significant difference between pre operative and post operative labs as postoperative Hb, Plts level decreased while INR, liver enzymes, bilirubin level increased than preoperative. There was significant difference between pelvic surgery and abdominal surgery of the studied patients regarding intra-operative blood loss as amount of blood loss intraoperative increased in abdominal surgery more than pelvic surgery. In this study, we compared between pelvic surgery and abdominal surgery regarding laboratory data post operative, and there were highly significant difference in labs postoperative between them as liver enzymes increased, Hb, Plts levels decreased in abdominal surgery more than pelvic surgery. In our study we compared between child B, child C classification patients there was highly significant difference between them regarding total time of surgery as time of surgery increased in child C patients more than child B patients, there were highly significant difference between them postoperative regarding hepatic encephalopathy, Bilirubin as they affected more in child C patients and there were highly significant difference between them regarding blood products transfusion as child C patients received more amounts of PRBCS, FFP, Plts transfusion than child B patients. Conclusion Patients with underlying liver disease have an increased surgical risk. Prediction of surgical risk is based on the degree of liver dysfunction, the type of surgery, and the preoperative clinical status of the patient as previously mentioned.