Hernia repair in cirrhotic patients.

I have read the review article by Silva et al.3 with great interest and contentment because some seem to forget about the problem of hernias in cirrhotic patients1. Silva et al.3 included relevant literature and indeed more information is necessary and I am awaiting their announced randomised controlled study. However, the Title “Abdominal and inguinal hernia in cirrhotic patients: what’s the best approach?” for me is misleading because their paper does not give an exact answer to the question and furthermore in the introduction section they do not say anything about the aims of this review article. To answer the question about the best approach it is not enough to discuss operation versus no operation or the timpoint for the operation (acute versus elective); it is moreover necessary to discuss different operation methods including the type of anaesthesia. I think there would be more cirrhotic patients eligible for elective surgery if for instance more procedures would be performed in local anaesthesia2. It would be very interesting if the authors could comment on this.