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Abstract
This study included a retrospective analysis of 45 patients with UH liver cirrhosis and ascites. They were admitted to the department of surgery of the national liver institute from the 1st of January 1995 to the jst of September 1999. The data of the patients were analyzed to detennine the preoperative management, operative interference, and postoperative course of those patients. The patients were divided into two groups according to the presence or absence of urgent complications. Group A, included 9 patients were admitted and underwent preoperative preparation for elective repair their UH. On the other hand, 36 patients were admitted with complicated and underwent surgery with repair of their hernias. All of the patients followed up for a minimal period of 6 months.
The mean age in group A was 38.1 years and the mean body weight was 57.8 Kg. Two patients had Child-Pugh’s class A, 3 patients had class B and patients had class C. The degree of ascites was classified by ultrasound into very minimal in 2 patients, mild in 1 patient, moderate in 2 patients had was tense and refractory to medical treatment of ascites in the remaining one patient. One patient had a past history of hematemesis due to esophageal varices and none of the patients had a history of encephalopathy. The degree ascites was decreased with medical treatment for about 5-15 days of hospitalization in 8 patients and on the other hand, it was refractory to medical treatment in the remaining one patient. Three patients had associated hernias, two inguinal, and one incisional hernia. All of these hernias were repaired in association with UH. All of the patients underwent surgery under general isoflurane anesthesia. Seven patients underwent conventional hernionaphy with transverse linear approximation of the edges of the rectus sheath, one patient had mesh hernioplasty (onlay technique) and the remaining patient had a concomitant herniorraphy with PVS implantation to