探讨在严格患者筛选与系统化围手术期管理前提下，将腹股沟疝合并肝硬化及中少量腹水（IH-LC-MA）患者纳入日间手术路径行腹股沟疝修补术的安全性与可行性，并总结关键管理要点。

回顾性分析2023年6月至2025年6月在首都医科大学附属北京朝阳医院普通外科中心疝和腹壁外科接受腹股沟疝修补术并纳入日间手术管理路径的IH-LC-MA患者的临床资料。收集患者基线特征、围手术期相关指标、住院时间、术后并发症及随访结局。

共纳入14例患者，均为男性，中位年龄为62.5（范围：33.0~77.0）岁。Child-Pugh分级A级6例、B级8例，术前超声检测腹水最大液性暗区中位深度为3.8（范围：1.6~8.5）cm。所有患者均在局部神经阻滞麻醉下顺利完成开放式Lichtenstein无张力疝修补术。中位手术时间为60（范围：30~80）min，中位术中出血量为5.0（范围：2.0~15.0）ml。所有患者均于48 h内出院，其中≤24 h者11例，>24 h且≤48 h者3例。中位随访时间14（范围：7~29）个月。随访期间，5例患者出现术后血清肿，均未经特殊处理自行吸收；未观察到切口感染、腹水渗漏、慢性疼痛、疝复发及肝性脑病或消化道大出血等严重并发症。患者总体满意度为100%。

在严格术前评估与准备、个体化麻醉及手术方案选择，以及精细化术后管理的前提下，日间手术模式用于IH-LC-MA患者的腹股沟疝修补术是安全、可行的。

To evaluate the safety and feasibility of ambulatory inguinal hernia repair in patients with inguinal hernia complicated by liver cirrhosis and mild to moderate ascites (IH-LC-MA) under strict patient selection and standardized perioperative management, and to summarize key management strategies.

A retrospective analysis was conducted on IH-LC-MA patients who underwent inguinal hernia repair and were managed under an ambulatory surgery pathway in the Division of Hernia and Abdominal Wall Surgery, Department of General Surgery, Beijing Chao-Yang Hospital, Capital Medical University between June 2023 and June 2025. Baseline characteristics, perioperative parameters, length of hospital stay, postoperative complications, and follow-up outcomes were collected and analyzed.

A total of 14 patients were included, all of whom were male, with a median age of 62.5 (range: 33.0 to 77.0) years old. Six patients were classified as Child-Pugh grade A and eight as grade B. The median depth of the largest fluid-dark zone in ascites prior to surgery was 3.8 (range: 1.6 to 8.5) cm. All patients underwent Lichtenstein hernia repair under local nerve block anesthesia successfully. Median operative time was 60 (range: 30 to 80) minutes, with median intraoperative blood loss of 5.0 (range: 2.0 to 15.0) ml. All patients were discharged within 48 hours, including 11 within ≤24 hours and 3 between >24 hours and ≤48 hours. The median follow-up time was 14 ( range: 7 to 29) months. During the follow-up period, five patients developed postoperative seromas, all of which resolved spontaneously without specific intervention. No serious complications were observed, including incisional infection, seroma leakage, chronic pain, hernia recurrence, hepatic encephalopathy, or major gastrointestinal hemorrhage. Overall patient satisfaction reached 100%.

With rigorous preoperative assessment and preparation, individualized anesthesia and surgical planning, and meticulous postoperative management, ambulatory surgery for patients with IH-LC-MA is a safe and viable mode.