간질환 환자의 수술 위험도 판정
The Surgical Risk in Patients with Liver Disease
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초록
간질환을 가진 환자들은 정상인에 비하여 수술 중 사망률과 수술 후 합병증 발생률이 높다. 그러므로 수술 전에 만성 간질환이 있는지를 철저히 확인하고 만성 질환의 심한 정도 및 수술의 종류 등에 따라 수술에 따른 위험성이 어느 정도인지 충분히 파악하여 수술여부를 결정하여야 한다. 즉, 세심한 수술 전 평가를 통하여 수술 위험이 높은 환자들을 찾아내어 수술을 피하고, 수술 전에 교정 가능한 요인들(복수, 혈액응고 장애)을 치료함으로써 수술 합병증을 최소화하도록 한다.
Abstract
Surgical procedures and administration of anesthesia can reduce blood flow to the liver. The reduction in blood flow can result in asymptomatic elevation of serum liver biochemical tests postoperatively in patients with normal liver function, but in patients with compromised liver function, hepatic decompensation can occur, leading to morbidity and mortality. Liver disease is common and patients with liver disease are frequently asymptomatic, the preoperative assessment of all patients undergoing surgery must do a careful history and physical examination to uncover risk factors and evidence of liver dysfunction. Operative risk correlates with the severity of the underlying liver disease and the nature of the surgical procedure. This review will consider the factors that contribute to peri-operative hepatic dysfunction and prediction of operative risk in patients with liver disease undergoing surgery other than liver transplantation.
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