Major abdominal surgeries including pancreatic resection are rarely performed in patients on chronic dialysis due to perioperative morbidity associated with end-stage renal disease. This case report presents a 71-year-old female on hemodialysis with pancreatic head cancer who underwent successful pancreaticoduodenectomy. The patient had the following severe comorbidities: type 2 diabetes mellitus, hypertension, and chronic kidney disease. Therefore, meticulous preoperative preparation, intraoperative care and postoperative management including hemodialysis and nutritional support were performed. Postoperative recovery was uneventful, bowel function was restored on day 5, and the patient was discharged in good condition. This case provides the feasibility of pancreaticoduodenectomy (also known as Whipple procedure) in carefully monitored patients, particularly those on dialysis, despite the increased risk of complications like cardiovascular, immune, and coagulation disorders. Brief literature review confirms that patients with end-stage renal disease can be considered for abdominal surgery with acceptable morbidity and mortality in complex surgical procedures.

Background/Objectives : Alcohol-related acute-on-chronic liver failure (ACLF) carries high early mortality, but prognostic evidence varies by definition, endpoint, and adjustment. We estimated short-term mortality and synthesized clinically useful predictors. Methods: PubMed/MEDLINE, Scopus, and Web of Science were searched to 25 June 2026 and, with a revised strategy, to 28 September 2026. Direct alcohol-related ACLF cohorts formed the core evidence base. Mortality was pooled using REML random-effects models with Hartung–Knapp confidence intervals and 95% prediction intervals (PIs); predictors were synthesized qualitatively. Risk of bias and certainty were assessed with QUIPS and GRADE. Results: Forty reports (35 independent cohorts) were included. Pooled mortality was 36.0% at 28/30 days (11 cohorts; 95% CI 28.9–43.8; PI 17.3–60.3%) and 50.2% at 90 days (11 cohorts; 95% CI 39.5–60.8; PI 19.2–81.0%), without significant differences between APASL/AARC- and EASL-CLIF-defined cohorts. Qualitatively, organ-failure burden, infection or sepsis, hepatic encephalopathy, renal dysfunction, shock, and higher MELD-, CLIF-, or AARC-based severity were the most consistent adverse signals; pooled predictor effects could not be estimated. Conclusions: About one-third of patients die by 28/30 days and half by 90 days, but mortality varies widely across settings. Predominantly very low-certainty predictor evidence supports framework-appropriate scores and repeated assessment rather than a universal cutoff.