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Esophagogastric devascularization without splenectomy in portal hypertension: safe and effective?

AbstractBACKGROUND:
Esophagogastric variceal hemorrhage is a life-threatening complication of portal hypertension. In this study, we compared the therapeutic effect of a novel surgical procedure, esophagogastric devascularization without splenectomy (EDWS), with the widely used modified esophagogastric devascularization (MED) with splenectomy for the treatment of portal hypertension.
METHODS:
Fifty-five patients with portal hypertension were included in this retrospective study. Among them, 27 patients underwent EDWS, and the other 28 patients underwent MED. Patients' characteristics, perioperative parameters and long-term follow-up were analyzed.
RESULTS:
The portal venous pressure was decreased by 20% postoperatively in both groups. The morbidity rate of portal venous system thrombosis in the EDWS group was significantly lower than that in the MED group (P=0.032). The 1- and 3-year recurrence rates of esophagogastric variceal hemorrhage were 0% and 4.5% in the EDWS group, and 0% and 8.7% in the MED group, respectively (P=0.631).
CONCLUSIONS:
EDWS is a safe and effective treatment for esophagogastric varices secondary to portal hypertension in selected patients. Patients treated with EDWS had a lower complication rate of portal venous system thrombosis compared with those treated with conventional MED.
AuthorsYan-Bin Ni, Peng-Ji Gao, Dong Wang, Zhao Li, Ji-Ye Zhu
JournalHepatobiliary & pancreatic diseases international : HBPD INT (Hepatobiliary Pancreat Dis Int) Vol. 14 Issue 3 Pg. 276-80 (Jun 2015) ISSN: 1499-3872 [Print] Singapore
PMID26063028 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Disease-Free Survival
  • Esophageal and Gastric Varices (diagnosis, etiology, surgery)
  • Female
  • Gastrointestinal Hemorrhage (diagnosis, etiology, surgery)
  • Hemostatic Techniques (adverse effects)
  • Humans
  • Hypertension, Portal (complications, diagnosis, physiopathology, surgery)
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Splenectomy (adverse effects)
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures (adverse effects)
  • Venous Pressure
  • Venous Thrombosis (etiology)

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