Dentistry and oral and maxillofacial surgery in the patient with liver disease: key messages for clinical practice
| Autor: | Selvaggia Brigo, Enrico Mancuso, Rinaldo Pellicano |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Liver Cirrhosis
congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Cirrhosis Dentistry Context (language use) Chronic liver disease 03 medical and health sciences Liver disease 0302 clinical medicine Epidemiology medicine Humans Decompensation business.industry Liver Diseases 030206 dentistry Perioperative medicine.disease Surgery Oral respiratory tract diseases Otorhinolaryngology Oral and maxillofacial surgery Surgery Oral Surgery business 030217 neurology & neurosurgery |
| Zdroj: | Minerva Stomatologica. 68 |
| ISSN: | 1827-174X 0026-4970 |
| DOI: | 10.23736/s0026-4970.19.04216-x |
| Popis: | The recent changes in terms of both epidemiology of chronic liver disease (CLD) and long-term survival of patients with CLD have had a great impact in the field of dentistry and oral and maxillofacial surgery. In this context, compared with the previous decades, today it is more probable to cure patients with CLD also at advanced stage (cirrhosis), that could remain asymptomatic for long, before the appearance of signs of decompensation. Hence, it is crucial to identify the patient with CLD and to define the stage of the latter. The main risks are the viral acquisition on the part of the operator or of the other patients, the risk of bleeding due to the impaired coagulation status or the risk of liver decompensation due to alterations in the metabolism of certain drugs leading to hepatotoxicity. Generally, it is appropriate to treat patients with CLD not yet evolved in cirrhosis or with compensated cirrhosis, in a primary care setting, whilst secondary care management should be reserved to those patients with decompensated cirrhosis (Child-Turcotte-Pugh's grade B or C) or compensated cirrhosis but with signs of thrombocytopenia or previous episodes of decompensation. In the latter case it is mandatory to quantify the perioperative risk. In this updated review the authors describe the practical approach to the patient with CLD. |
| Databáze: | OpenAIRE |
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