Cirrhotic liver disease is an important cause of peri-operative morbidity and mortality in general surgical patients. Early recog-nition and optimization of liver dysfunction is imperative before any elective surgery. Patients with MELD <12 or classified asChild A have a higher morbidity and mortality than matched controls without liver dysfunction, but are generally safe for electiveprocedures with appropriate patient education.

“Early-stage liver disease (MELD < 12 or CTP A) is associated with a higher morbidity and mortality than matched controls but does not require alterations in management apart from
patient counseling. While there are data for many specific elective procedures, general guidelines are as follows: patient with Child A or MELD < 12 are generally safe for elective
procedures, Child B or MELD 12–19 should have aggressive optimization and referral for liver transplant, and Child C or MELD > 20 have a prohibitively high surgical risk (mortality
> 40%) and should undergo transplantation before any elective procedures”

Hickman L, et al Non-Hepatic Abdominal Surgery in Patients with Cirrhotic Liver Disease. J Gastrointest Surg. 2019 Mar;23(3):634-642. Free Full Text