CLINICAL MANIFESTATIONS AND SURGICAL COMPLICATIONS OF CHRONIC LIVER DISEASE

Abstract

Introduction: Chronic liver disease encompasses a set of progressive liver diseases that lead to fibrosis and may progress to cirrhosis and liver failure. Its clinical manifestations include jaundice, ascites, hepatic encephalopathy, esophageal varices, and changes in hemostatic metabolism, which increase the risk of serious complications. Patients with chronic liver disease are more susceptible to infections, malnutrition, and renal dysfunction, factors that negatively impact their clinical evolution and prognosis. In the surgical context, these conditions impose additional challenges, since liver impairment directly affects the inflammatory response, tissue healing, and the metabolism of anesthetics and drugs. Objective: To analyze the main clinical manifestations of chronic liver disease and associated surgical complications, highlighting the risk factors and therapeutic challenges in the approach to these patients. Methodology: The study was conducted following the PRISMA checklist guidelines, with searches in the PubMed, SciELO and Web of Science databases. Five descriptors were used in Portuguese and English: “Chronic Hepatopathy”, “Liver Cirrhosis”, “Surgical Complications”, “Perioperative Bleeding” and “Acute Liver Failure”. The inclusion criteria include original studies, systematic reviews and clinical trials that investigated clinical manifestations and surgical complications in patients with chronic liver disease. Articles that did not directly address the topic, studies with inadequate methodology and publications in languages ​​other than Portuguese, English and Spanish were excluded. Results: The studies analyzed showed that preoperative hepatic decompensation was associated with higher rates of surgical complications, with hemorrhage being one of the most prevalent due to changes in coagulation. Patients with advanced cirrhosis had an increased risk of postoperative liver failure, in addition to greater susceptibility to hospital infections. Conclusion: The clinical manifestations of chronic liver disease compromised the stability of patients, increasing surgical risks and the incidence of postoperative complications. Detailed preoperative evaluation, combined with individualized multidisciplinary management, was essential to reduce morbidity and mortality and improve clinical outcomes in these patients.