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Introduction: Liver surgery and hepatic encephalopathy (HE) are closely linked, with HE representing a significant neuropsychiatric complication resulting from liver dysfunction. During surgical procedures on the liver, the accumulation of toxins, especially ammonia, can worsen HE symptoms, which range from mental confusion to coma. This review focuses on understanding the neuropsychiatric effects of liver surgery and developing management strategies to improve clinical outcomes for affected patients. Objective: To investigate how surgical procedures on the liver contribute to the development or worsening of hepatic encephalopathy. Methodology: The Cochrane, Scielo and Medline databases were used, searching for articles published between 2020 and 2024, in Portuguese or English. Final Considerations: Liver surgery can intensify hepatic encephalopathy (HE) due to the accumulation of neuroactive toxins, such as ammonia. As a result, patients with advanced cirrhosis are particularly susceptible. Therefore, a multidisciplinary approach, including the use of interventions such as lactulose and rifaximin, is crucial to minimize these effects and improve patients' quality of life.
References
Ashok Jhajharia, Singh S, Jana S, Prachis Ashdhir, Sandeep Nijhawan. Intravenous versus oral “l-ornithine-l-aspartate” in overt hepatic encephalopathy: a randomized comparative study. Scientific reports. 2024 May 24;14(1).
Ferraz LR, Figueiredo LFP de. Diagnóstico de encefalopatia hepática. Revista da Associação Médica Brasileira [Internet]. 2004 Apr 1;50:116–6. Available from: https://www.scielo.br/j/ramb/a/XnfqrsTxctRdbmc47FMYmVq/?lang=pt
Godoy JL de, Matias JEF, Coelho JCU. REGENERAÇÃO HEPÁTICA: O MITO DE PROMETEU REVISADO. Brazilian Journal of Transplantation [Internet]. 2006 Mar 1 [cited 2024 Abril 15];9(2):535–9. Available from: https://bjt.emnuvens.com.br/revista/article/view/362
Kulkarni AV, Avadhanam M, Karandikar P, Rakam K, Gupta A, Simhadri V, et al. Antibiotics With or Without Rifaximin for Acute Hepatic Encephalopathy in Critically Ill Patients With Cirrhosis: A Double-Blind, Randomized Controlled (ARiE) Trial. The American Journal of Gastroenterology [Internet]. 2024 May 1;119(5):864–74. Available from: https://pubmed.ncbi.nlm.nih.gov/37942950/
Machado Júnior PAB, Ziliotto RD, Ferreira APVN, Buson TM, Couto CM do, Pissaia Junior A. USE OF THE STROOP ENCEPHALAPP FOR COVERT HEPATIC ENCEPHALOPATHY SCREENING IN CIRRHOTIC PATIENTS IN SOUTHERN BRAZIL. Arquivos De Gastroenterologia [Internet]. 2020 [cited 2023 Jan 16];57(4):399–403. Available from: https://pubmed.ncbi.nlm.nih.gov/33237215/
Raimundo S, Chalub S, De Oliveira M, Fonseca C. Artigo Original Análise de 5 anos de seguimento de hepatectomias em portadores de tumor hepático [Internet]. [cited 2024 Abril 15]. Available from: https://www.sbhepatologia.org.br/cientifico/ged/2012/ged01_5.pdf
Santos CN, Cosac LMDP. ENCEFALOPATIA HEPÁTICA ETIOLOGIA, SINTOMATOLOGIA, FISIOPATOLOGIA E MANEJO CLÍNICO / HEPATIC ENCEPHALOPATHY ETIOLOGY, SYMPTOMATOLOGY, PATHOPHYSIOLOGY AND CLINICAL MANAGEMENT. Brazilian Journal of Development. 2020;6(10):76197–208.
Strauss E, Reis M. FISIOPATOLOGIA DA ENCEFALOPATIA HEPÁTICA [Internet]. Available from: https://sbhepatologia.org.br/pdf/encefalopatia/d8.pdf
Sultanik P, Kheloufi L, Leproux A, Bouzbib C, Mouri S, Santiago A, et al. Other causes of neurocognitive impairment than covert hepatic encephalopathy (CHE) are very frequent, either alone or associated with CHE, in cirrhotic patients with cognitive complaints. Aliment Pharmacol Ther [Internet]. 2024 [cited 2024 Abril 15]; Available from: https://pesquisa.bvsalud.org/portal/resource/pt/mdl-38973133
Yan W, Yao Z, Ou Q, Ye G. Establishment and validation of a prognosis nomogram for MIMIC-III patients with liver cirrhosis complicated with hepatic encephalopathy. BMC Gastroenterology [Internet]. 2023 Sep 28 [cited 2023 Nov 2];23(1):1–15. Available from: https://web.s.ebscohost.com/ehost/detail/detail?vid=8&sid=0b4d6e44-9eb0-433b-aa16-ef99bff13352%40redis&bdata=JkF1dGhUeXBlPWlwLHNzbyZzaXRlPWVob3N0LWxpdmU%3d#AN=172395859&db=a9h
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Copyright (c) 2024 Allison Gonçalves Silva Dutra Costa , Janderson de Castro e Silva, Gabriela Vargas Carneiro, Marcel Pietro Miranda da Silva, Natalia Roquette Giachetto, Iago Pordeus Casimiro, Clara Vidal Barros, Leandro Barroso Barbosa, Pedro Henrique Silva Fernandes , Estevão dos Santos Diniz , Thiago Venicius Silva Duarte , Tulio Saltarello , Camilla Cristina Alves Ribeiro