Inguinal hernia repair in patients with cirrhosis is not associated with increased risk of complications and recurrence

World J Surg. 2011 Jun;35(6):1229-33; discussion 1234. doi: 10.1007/s00268-011-1007-9.


Background: Although inguinal hernia in patients with liver cirrhosis (LC) is not uncommon, literature comparing operative complications and long-term recurrence rate after inguinal hernia repair in LC patients and non-LC patients is limited.

Methods: A total of 780 eligible patients including 129 (16.5%) patients with LC underwent inguinal hernia repair with the standard McVay procedure by a single surgeon over a 10-year period. Patients were prospectively registered and clinical data were analyzed retrospectively.

Results: In the LC group, 45 patients were of Child-Turcotte-Pugh (CTP) class A (34.9%), 66 were class B (51.1%), and 18 were class C (14.0%). Eighty-one patients with LC (62.8%) had ascites at the time of operation. Postoperative complications occurred in 14 LC patients (10.9%). Complication rate was unrelated to CTP class (A:B:C=11.1%:9.1%:16.7%; P=0.69) and was not higher than among non-LC patients (6.8%; P=0.11). Two LC patients (1.6%) of CTP class C died postoperatively from hepatic failure. In LC group patients, median follow-up was 22.9 months and recurrence developed in three (2.3%). Cumulative recurrence rates were not significantly different between the LC and non-LC patient groups (P=0.87). The cumulative rate of contralateral side hernia development was also similar between the two groups (P=0.63).

Conclusions: Our results indicate that the incidence of postoperative complications and long-term recurrence after inguinal hernia repair in LC patients does not differ from that in non-LC patients. Elective repair of symptomatic inguinal hernia in patients with cirrhosis should be advocated.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hernia, Inguinal / complications*
  • Hernia, Inguinal / diagnosis
  • Hernia, Inguinal / surgery*
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / surgery
  • Male
  • Middle Aged
  • Pain, Postoperative / physiopathology
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / physiopathology
  • Recurrence
  • Reference Values
  • Retrospective Studies
  • Risk Assessment
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / physiopathology
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • Young Adult