Adverse effects of exploratory laparotomy in patients with unsuspected liver disease

Author:

Powell-Jackson P1,Greenway B1,Williams R1

Affiliation:

1. The Liver Unit, King's College Hospital and Medical School, Denmark Hill, London SE5, England

Abstract

Abstract Thirty-six patients were referred to the Liver Unit between 1971 and 1980 after unsuspected liver disease had been found at laparotomy. The preoperative diagnosis had been extrahepatic biliary obstruction in 16 patients and intra-abdominal malignancy in 15. Misdiagnosis resulted from insufficient attention to the history and physical signs in 31 patients and omission or misinterpretation of liver function tests and of other hepatobiliary investigations in the remaining 5 patients. The morbidity and mortality of the 36 patients within 1 month of operation was 61 per cent and 31 per cent respectively. All patients with viral or alcoholic hepatitis died, and severe complications, which included bacterial peritonitis, wound dehiscence and hepatic failure, developed in 13 of 15 in whom ascites due to cirrhosis or the Budd–Chiari syndrome was present before operation.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference7 articles.

1. The increased mortality rate of open liver biopsy in alcoholic hepatitis;Greenwood;Surg. Gynecol. Obstet.,1972

2. Surgery in acute hepatitis;Harville;JAMA,1963

3. The surgical risk in cirrhosis of the liver;Lindenmuth;Arch. Surg.,1963

4. Bacteraemia in association with hepatocellular and hepatobiliary disease;Jones;Postgrad. Med. J.,1967

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