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.