Primary biliary cirrhosis surgery: Difference between revisions
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==Overview== | ==Overview== | ||
The mainstay of treatment for primary [[Primary biliary cirrhosis|primarybiliary cirrhosis]] is medical therapy. Surgery is usually reserved for patients with either decompensated [[cirrhosis]] and endstage [[liver failure]] who do not show any improvement with medical therapy. | The mainstay of treatment for primary [[Primary biliary cirrhosis|primarybiliary cirrhosis]] is medical therapy. Surgery is usually reserved for patients with either decompensated [[cirrhosis]] and endstage [[liver failure]] who do not show any improvement with medical therapy. | ||
==Indications== | ==Indications== | ||
Indications for | Indications for liver transplantation include: | ||
*Decompensated [[cirrhosis]] | *Decompensated [[cirrhosis]] | ||
*Endstage [[liver failure]]: | *Endstage [[liver failure]]: | ||
**Refractory [[ascites]] | **Refractory [[ascites]] | ||
**Recurrent [[spontaneous bacterial peritonitis]] | **Recurrent [[spontaneous bacterial peritonitis]] | ||
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**[[Hepatorenal syndrome|Hepatorenal syndrome type I]] | **[[Hepatorenal syndrome|Hepatorenal syndrome type I]] | ||
**[[Hepatocellular carcinoma]] | **[[Hepatocellular carcinoma]] | ||
== Surgery == | |||
*The mainstay of treatment for [[Primary biliary cirrhosis|primarybiliary cirrhosis]] is medical therapy. [[Liver transplantation]] is usually reserved for patients with either: | |||
**Decompensated [[cirrhosis]] | |||
**Endstage [[liver failure]] | |||
*[[Liver transplantation]] is considered to be the only definitive treatment for [[Primary biliary cirrhosis|PBC]] with decompensated [[cirrhosis]] and endstage [[liver failure]]. | |||
*The 5 year survival rate following liver transplantation is upto 85% which is the highest in any liver disease. | |||
*'''"Model for end-stage liver disease” (MELD)''' score is used to govern priority for [[liver transplantation]].<ref name="pmid12512033">{{cite journal| author=Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P et al.| title=Model for end-stage liver disease (MELD) and allocation of donor livers. | journal=Gastroenterology | year= 2003 | volume= 124 | issue= 1 | pages= 91-6 | pmid=12512033 | doi=10.1053/gast.2003.50016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12512033 }} </ref> | |||
*The score range between 6 and 40 and is calculated using a logarithmic assessment of three objective and [[reproducible]] variables including: | |||
**[[Total serum bilirubin]] | |||
**[[Creatinine]] concentrations | |||
**[[International normalized ratio]] | |||
== Recurrence == | |||
*In about 20% of the patients the recurrence of [[Primary biliary cirrhosis|primarybiliary cirrhosis]] occurs between 3 and 7 years after [[Liver transplantation|liver transplantation]]. | |||
==References== | ==References== | ||
Revision as of 15:42, 6 February 2018
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Primary Biliary Cirrhosis Microchapters |
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Differentiating Primary Biliary Cirrhosis from other Diseases |
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Diagnosis |
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Primary biliary cirrhosis surgery On the Web |
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American Roentgen Ray Society Images of Primary biliary cirrhosis surgery |
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Risk calculators and risk factors for Primary biliary cirrhosis surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Overview
The mainstay of treatment for primary primarybiliary cirrhosis is medical therapy. Surgery is usually reserved for patients with either decompensated cirrhosis and endstage liver failure who do not show any improvement with medical therapy.
Indications
Indications for liver transplantation include:
- Decompensated cirrhosis
- Endstage liver failure:
- Refractory ascites
- Recurrent spontaneous bacterial peritonitis
- Recurrent variceal hemorrhage
- Hepatic encephalopathy
- Hepatorenal syndrome type I
- Hepatocellular carcinoma
Surgery
- The mainstay of treatment for primarybiliary cirrhosis is medical therapy. Liver transplantation is usually reserved for patients with either:
- Decompensated cirrhosis
- Endstage liver failure
- Liver transplantation is considered to be the only definitive treatment for PBC with decompensated cirrhosis and endstage liver failure.
- The 5 year survival rate following liver transplantation is upto 85% which is the highest in any liver disease.
- "Model for end-stage liver disease” (MELD) score is used to govern priority for liver transplantation.[1]
- The score range between 6 and 40 and is calculated using a logarithmic assessment of three objective and reproducible variables including:
- Total serum bilirubin
- Creatinine concentrations
- International normalized ratio
Recurrence
- In about 20% of the patients the recurrence of primarybiliary cirrhosis occurs between 3 and 7 years after liver transplantation.
References
- ↑ Wiesner R, Edwards E, Freeman R, Harper A, Kim R, Kamath P; et al. (2003). "Model for end-stage liver disease (MELD) and allocation of donor livers". Gastroenterology. 124 (1): 91–6. doi:10.1053/gast.2003.50016. PMID 12512033.