Alcoholic liver disease surgery

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Alcoholic liver disease Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2] Aditya Govindavarjhulla, M.B.B.S. [3]

Overview

The most important part of treatment is to stop using alcohol completely. If liver cirrhosis has not yet occurred, the liver can heal if you stop drinking alcohol. An alcohol rehabilitation program or counseling may be necessary to break the alcohol addiction. Vitamins, especially B-complex and folic acid, can help reverse malnutrition.

Surgery

Liver transplant

  • If cirrhosis develops, there is a need to manage the complications of cirrhosis. It may need a liver transplant.[1]
  • Orthotopic liver transplant (OTC) is the definitive surgical treatment for hepatic failure associated with alcoholic liver disease.[2]
  • Due to the nature of the disease being considered as self induced and the possibility of recidivism most patients are not considered for OLT.[3][4]
  • These patients should be evaluated for likelihood of long term abstinence from alcohol, a six month period of abstinence before transplant may even allow clinical improvement.[5]

2010 AASLD/ACG Alcoholic Liver Disease Guidelines (DO NOT EDIT)[6]

Liver Transplantation (DO NOT EDIT)[6]

Class I
1. " Appropriate patients with end-stage liver disease secondary to alcoholic cirrhosis should be considered for liver transplantation, just as other patients with decompensated liver disease, after careful evaluation of medical and psychosocial candidacy. In addition, this evaluation should include a formal assessment of the likelihood of long-term abstinence. (Level of evidence: B) "

References

  1. Biselli M, Gramenzi A, Del Gaudio M, Ravaioli M, Vitale G, Gitto S, Grazi GL, Pinna AD, Andreone P, Bernardi M (2010). "Long term follow-up and outcome of liver transplantation for alcoholic liver disease: a single center case-control study". J. Clin. Gastroenterol. 44 (1): 52–7. doi:10.1097/MCG.0b013e3181a390a8. PMID 19581813.
  2. Arteel G, Marsano L, Mendez C, Bentley F, McClain CJ (2003). "Advances in alcoholic liver disease". Best Pract Res Clin Gastroenterol. 17 (4): 625–47. PMID 12828959.
  3. O'Grady JG (2006). "Liver transplantation alcohol related liver disease: (deliberately) stirring a hornet's nest!". Gut. 55 (11): 1529–31. doi:10.1136/gut.2005.090506. PMC 1860102. PMID 17047102.
  4. Mackie J, Groves K, Hoyle A, Garcia C, Garcia R, Gunson B, Neuberger J (2001). "Orthotopic liver transplantation for alcoholic liver disease: a retrospective analysis of survival, recidivism, and risk factors predisposing to recidivism". Liver Transpl. 7 (5): 418–27. doi:10.1053/jlts.2001.23789. PMID 11349262.
  5. Lucey MR, Brown KA, Everson GT, Fung JJ, Gish R, Keeffe EB, Kneteman NM, Lake JR, Martin P, McDiarmid SV, Rakela J, Shiffman ML, So SK, Wiesner RH (1997). "Minimal criteria for placement of adults on the liver transplant waiting list: a report of a national conference organized by the American Society of Transplant Physicians and the American Association for the Study of Liver Diseases". Liver Transpl Surg. 3 (6): 628–37. PMID 9404965.
  6. 6.0 6.1 "www.aasld.org" (PDF). Retrieved 2012-10-27.

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