Clinical aspects of hepatic disease

Hepatic disease has a high prevalence globally and is one of the major causes of mortality. Patients with hepatic disease are also associated with an increased morbidity and mortality after surgery and anaesthesia. Several scoring systems have been used for perioperative risk stratifications. Impaired hepatic synthetic and metabolic functions create multiple pathophysiological pathways in the body, resulting in extensive extrahepatic manifestations. Therefore, careful preoperative assessment of various systems is warranted to assess different organ function, which allows patient optimization and careful perioperative planning. Liver is a major organ for drug metabolism, extra caution must be taken when choosing the type and dosage of medication.