348 Obstetrics and Gynecology Board Review •••
❍ When should dialysis-dependent patients be dialyzed before surgery?
Within 24 hours of surgery.
❍ What classification has been used to predict liver disease and risk assessment for surgery?
The Child’s classification taking into account serum bilirubin, albumin, ascites, encephalopathy, and nutritional
status.
❍ In patients with ascites and hydrothorax, when should preoperative thoracentesis and paracentesis be
considered?
When massive ascites and hydrothorax cause marked pulmonary or abdominal symptoms.
❍ How does viral hepatitis affect timing of surgery?
Perioperative morbidity approaches 12%, and mortality 9.5%. Thus surgery should be deferred until convalescence
if possible.