Several studies have demonstrated increased morbidity and mortality in patients with cirrhosis undergoing anesthesia and surgery. Cirrhosis is a chronic liver disease, which may affect all body systems. The severity of the disease, assessed by the Child-Pugh classification, has a substantial effect on patient outcome. The extent of surgery and co-morbid conditions also have a major impact. In the past few years, changes have been made in the diagnosis, preoperative preparation, surgical and anesthetic management and perioperative care of patients with liver disease. The aim of this review is to examine whether these changes have resulted in improved perioperative outcomes.
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