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Predicting and optimising risks for non-hepatic surgery in patients with cirrhosis: insights from the #FGDebate
  1. Rex Wan-Hin Hui1,
  2. Nadir Abbas2,3,
  3. Philip Dunne4,
  4. Dhiraj Tripathi2,5
  1. 1 Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
  2. 2 Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
  3. 3 The Liver Unit, Queen Elizabeth Hospital, Birmingham, UK
  4. 4 Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
  5. 5 The Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Rex Wan-Hin Hui, Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong; huirex{at}connect.hku.hk

https://doi.org/10.1136/flgastro-2023-102510

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    The Frontline Gastroenterology Twitter-debate (#FGDebate) in April 2023 focused on risks of non-hepatic surgery in patients with cirrhosis and was based on the BSG and BASL guidelines.1 The event generated 186 tweets and >292 000 impressions.

    Prognostic scores

    The debate kicked-off with a case presentation, followed by discussion on prognostic scores for estimating surgical risks. Among online participants, 53.2% chose the Child-Turcotte-Pugh (CTP) or Model for End-stage Liver Disease (MELD) scores for risk prediction. Other scores chosen included the VOCAL-Penn Score2 (26.2%), Mayo Surgical Score3 (16.3%) and Hepatic Venous Pressure Gradient (HVPG) (4.3%). Most respondents chose CTP or MELD as these were familiar and tried-and-tested. However, neither CTP or MELD truly assesses the presence or severity …

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    Footnotes

    • Twitter @RexWHHui, @Nadirabbas_x

    • Contributors RW-HH drafted the initial manuscript. NA, PD and DT provided critical appraisal and revised the manuscript. All authors have reviewed and approved the final version of this manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.