Outcomes of inguinal hernia repair in cirrhotics: a single tertiary centre experience.

Abstract

Patients with liver cirrhosis are at a higher risk of perioperative anaesthetic and surgical complications. Surgical repair of abdominal wall hernias in these patients has been widely discouraged. The main objective of this study was to evaluate the post-operative outcomes of patients with liver cirrhosis after inguinal hernia repair at a single institution. A retrospective review of a prospectively maintained database of 31 patients with liver cirrhosis undergoing inguinal hernia repair between 2006 and 2016 was undertaken. Data in relation to patient demographics, clinicopathological characteristics, morbidity and mortality were collected. Thirty-one patients with median Model for End-stage Liver Disease score of 14 (7-36) underwent inguinal hernia repair within a 10-year period of our study. There was one mortality in a patient with Model for End-stage Liver Disease score of 36 who presented with a strangulated hernia. Only one patient required return to theatre for the evacuation of haematoma and one patient developed a recurrent hernia in 1-year follow up. Inguinal hernia repair in patients with cirrhosis is a safe procedure to perform in the elective setting. Nevertheless, significant consideration must be given in performing these operations in centres with liver transplant units due to their extensive experience in pre-operative optimization to reduce the risk of hepatic decompensation.