Despite of advances in modern surgical and intensive care treatment mortality seems to remain high in patients with liver cirrhosis undergoing nonhepatic general surgery. In the few existing articles mortality was reported as high as 70% in patients with poor liver function (high CHILD- or MELD-score). Since data are scarce we analyzed our recent experience with cirrhotic patients undergoing emergent or elective nonhepatic general surgery since 2001 in a German University hospital.Methods: Since 2001 138 nonhepatic general surgical procedures (99 intraabdominal, 39 abdominal wall) were performed in patients with proved liver cirrhosis. Liver cirrhosis was preoperatively classified according to the CHILD- (41 CHILD A; 59 B, 38 C) and the MELD-score (MELD median 13). Sixty-nine (50%) of the patients underwent emergent operations. Most abdominal wall operations were for hernias. Intraabdominal operations consisted of GI-tract procedures (n=51), cholecystectomies (n=15) and various others (n=33). Perioperative data were gained by retrospective analysis. The electronic hospital charts included all data for classification of cirrhosis (CHILD, MELD).Results: Overall mortality of all 138 patients was 28% (10% elective surgery, 45% emergent surgery; p<0.001). Mortality was higher after intraabdominal than after abdominal wall operations (35% vs. 8%; p=0.001) or in patients requiring transfusions (47% vs. 6% without transfusions; p<0.001). Mortality increased with the CHILD-score: 10% (Child A), 17% (B), 63% (C; p<0.001) and the MELD-score (12% MELD 6-11; 18% MELD 12-17; 69% MELD > 17; p<0.001). Patients requiring surgery for bleeding or for perforation/peritonitis (n=34) showed a higher mortaliy than patients without these indications (56% vs. 18; p<0.01). In multivariate risk factor analysis the CHILD-/MELD-scores and transfusions (all p<0.01) but not the indication for surgery or location (intraabdominal vs. abdominal wall) were independent risk factors for a lethal outcome.Conclusions: Our results demonstrate that perioperative mortality remains high in patients with liver cirrhosis undergoing general surgery. Patients with poor liver function and/or need for blood transfusions even had a very high mortality. In our experience both the CHILD- and the MELD-score significantly predicted postoperative mortality. Both scores may, therefore, be applied to preoperatively predict outcome and modify management in patients with liver cirrhosis.