Long-term prognosis of non-shunt operation for idiopathic portal hypertension.

Abstract

This report presents 46 Japanese patients with idiopathic portal hypertension (IPH) in whom non-shunt operation was performed for the management of esophageal varices. Non-shunt operation included transthoracic esophageal transection (Sugiura's procedure) in 37 patients, transabdominal esophageal transection (TAET) in 3 patients, and Hassab's procedure in 6 patients. Rates of postoperative variceal eradication were: 78.4% by Sugiura's procedure; 100% by TAET; and 50% by Hassab's procedure. The cumulative rates for recurrent varices and recurrent bleeding were 3.9%, and 5.1%, respectively, at 5 years, and 8.9% and 9.8% at both 10 and 15 years. Only 3 patients required additional endoscopic injection sclerotherapy to treat recurrent varices. Although 3 patients developed upper gastrointestinal bleeding, the source of hemorrhage was esophageal varices in 1, and portal hypertensive gastropathy in 2; none of the patients died from bleeding. Actuarial survival for all patients was 87.5% at 5 years, 77.9% at 10 years, and 58.8% at 15 years. There were no deaths within the first 30 days after surgery. These results show that non-shunt operation is useful in preventing bleeding from esophageal varices in patients with IPH.

• Authors: K Ohashi, K Kojima, M Fukazawa, T Beppu, S Futagawa
• Journal: Journal of gastroenterology (J Gastroenterol) Vol. 33 Issue 2 Pg. 241-6 (Apr 1998) ISSN: 0944-1174 [Print] Japan
• PMID: 9605956 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Child
• Esophageal and Gastric Varices (surgery)
• Esophagus (surgery)
• Female
• Gastrointestinal Hemorrhage (surgery)
• Humans
• Hypertension, Portal (mortality, surgery)
• Male
• Methods
• Middle Aged
• Prognosis
• Recurrence
• Sclerotherapy
• Survival Rate
• Time Factors
• Treatment Outcome