The perioperative challenge of umbilical hernias management in chronic liver disease: a multicentric comparative study

Khedr, Ehab M.; Awad, Selmy S.; Asiri, Majed; AlThomali, Musab; Kaheel, Esraa J.; Alkhammash, Shumukh; Altalhi, Abdullah; Atallah, Hashim M.; Alshehri, Hamed A.; Al-Amri, Nadiah G.; Assmary, Zahra′a A.; Alotaibi, Abdulaziz F.; Kaabi, Manal A.; Alshamrani, Abdullah A.; Alzahrani, Azzah; Almogathali, Malak F.; Salim, Abdou; Tarabay, Ahmed

doi:10.4103/ejs.ejs_86_23

The perioperative challenge of umbilical hernias management in chronic liver disease: a multicentric comparative study

Authors

Abstract

Background
Umbilical hernias are likely to develop in liver cirrhosis patients with ascites as the disease progresses. It is debatable how to handle cirrhotic patients who have an umbilical hernia. Our goal was to examine the perioperative outcome, safety, and efficacy of surgical management of umbilical hernia in ascitic patients using anatomical repair and intraperitoneal mesh repair.
Methods
180 patients who reported to between June 2017 and September 2022 with umbilical hernias complaints related to chronic liver disease were included in the study and divided into three groups: − Group A (56 cases) 4 instances were lost to followup, Group B (60 cases), and Group C (60 cases).
Results
There was a little difference between cases treated surgically and ones treated conservatively. Typically, child B was involved. In group A, 34 patients (60.7%) experienced solitary or combined problems in total. Of these, 14 candidates (25%) involved strangling, eight (14.3%) involved blockage, and twelve (21.4%) involved leaking hernias. Four instances (6.7%) of seroma, four cases (6.7%) of hematoma, twelve cases (20%) of ascitic leak, 32 cases (53.3%) of recurrence, and four cases (5.6%) of encephalopathy were in group B cases. In group C, there were 16 instances (13.3%) of ascetic leak, 12 cases (20%) of wound infection, 12 cases (20%) of seroma, ten cases (16.7%) of recurrence, and four cases (6.7%) of encephalopathy.
Conclusion
It is advised to do elective treatment for umbilical hernias. mesh reinforcement of abdominal wall hernias is more common as it has a lower risk of hernia recurrence.

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