{"doi":"10.1007/s11901-025-00697-4","title":"Pre-Operative Assessment of Patients with Cirrhosis for Extrahepatic Surgery","abstract":"Purpose of Review: Patients with cirrhosis are at increased risk of peri-operative morbidity and mortality compared to those without cirrhosis, requiring careful pre-operative assessment of their liver disease, extra-hepatic comorbidities, and surgery-specific risk factors. Recent Findings: Adverse surgical outcomes in this population are often related to complications of advanced liver disease, including portal hypertension, impaired hemostasis, malnutrition/sarcopenia, and infection. Risk prediction tools, including the Child-Turcotte-Pugh score, Model for End-Stage Liver Disease score, Mayo Risk Score, and VOCAL-Penn Score, can be used to estimate post-operative mortality and support clinical decision-making when assessing surgical candidacy. Several common procedures, including hernia repair, laparoscopic cholecystectomy, and sleeve gastrectomy, are well-tolerated in appropriate candidates. Pre-procedural transplant evaluation and referral to a high-volume cirrhosis surgery center should be considered when feasible. Summary: This review discusses the pathophysiological mechanisms underlying increased peri-operative risk in cirrhosis, the application of surgical risk scores, liver-related contraindications to surgery, and specific considerations for several common procedures.","journal":"Current Hepatology Reports","year":2025,"id":567550,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9544,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":298804,"name":"Nadim Mahmud","orcid":"0000-0003-1889-3954","position":1,"is_corresponding":false},{"id":1471563,"name":"Claire Durkin","orcid":"0000-0002-9532-0765","position":0,"is_corresponding":true}],"reference_count":114,"raw_metadata":null,"created_at":"2026-07-19T02:56:44.340853Z","pmid":"40487931","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}