Perioperative management and nutrition in patients with liver and biliary tract disease

Abstract Patients with liver and biliary tract disease present unique critical challenges to the perioperative physician. Involvement of a multidisciplinary team with expertise in handling critically ill patients with cirrhosis, a thorough understanding and evaluation of the altered pathophysiology in this cohort of patients, and meticulous planning of timing and other perioperative strategies can help to achieve better outcomes during patients’ perioperative course. Risk minimization with attempts to optimize inherent conditions in various organ systems should be performed whenever possible, especially for elective surgeries. It is also important to decide when to defer surgery and the patient’s family should be involved in making an informed decision.