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Results of modified Sugiura operation in variceal bleeding in cirrhotic and noncirrhotic patients.
Hepatogastroenterology. 2003 May-Jun; 50(51):784-8.H

Abstract

BACKGROUND/AIMS

Esophageal variceal bleeding is a major complication of portal hypertension and the optimal therapeutic modality for each individual patient differs. We reviewed the results of modified Sugiura procedure in patients with variceal bleeding of esophagus.

METHODOLOGY

We retrospectively reviewed the charts of 13 patients who were subjected to modified Sugiura procedure (transabdominal esophagogastric devascularization + esophageal stapled transection + splenectomy) for bleeding esophageal varices between 1996 and 2001. Three patients disappeared from routine follow-up and were excluded from the study. Survival, rebleeding and encephalopathy were evaluated.

RESULTS

The mean age was 46 (18-56). The etiology of portal hypertension was cirrhosis of liver in six (60%) and portal vein thrombosis in four (40%). One patient had Child-Pugh's Class A, two had Class B and three had Class C cirrhosis. Previous variceal bleeding were confirmed by endoscopy in all patients who had recurrent variceal bleeding despite treatment with beta-blockers (three patients) or endoscopic sclerotherapy +/- band ligation (seven patients). Two were subjected to emergency surgery while the remaining eight were operated on electively. No postoperative mortality was seen. The bleeders were stopped immediately in the emergent cases. During a mean follow-up of 27 (4-53) months, one (10%) patient suffered from encephalopathy and one (10%) from rebleeding at 20th and 28th months after the operation respectively. Three (30%) patients with Child C cirrhosis died due to bleeding (one) and hepatic failure (two) at 4, 25, and 28 months after the surgery. The prognoses of other patients are well at the present time.

CONCLUSIONS

In our small number of patients, modified Sugiura procedure was found to be a safe and effective procedure for urgent and long-term control of bleeding varices in patients with portal hypertension due to cirrhosis and noncirrhotic etiology. The outcomes are encouraging in noncirrhotic patients and cirrhotic patients with good liver functions.

Authors+Show Affiliations

Ataturk Training and Research Hospital, 2nd General Surgery Department, Izmir, Turkey. mhaciyanli@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

12828085

Citation

Haciyanli, Mehmet, et al. "Results of Modified Sugiura Operation in Variceal Bleeding in Cirrhotic and Noncirrhotic Patients." Hepato-gastroenterology, vol. 50, no. 51, 2003, pp. 784-8.
Haciyanli M, Genc H, Halici H, et al. Results of modified Sugiura operation in variceal bleeding in cirrhotic and noncirrhotic patients. Hepatogastroenterology. 2003;50(51):784-8.
Haciyanli, M., Genc, H., Halici, H., Kumkumoglu, Y., Gur, O. S., & Ozturk, T. (2003). Results of modified Sugiura operation in variceal bleeding in cirrhotic and noncirrhotic patients. Hepato-gastroenterology, 50(51), 784-8.
Haciyanli M, et al. Results of Modified Sugiura Operation in Variceal Bleeding in Cirrhotic and Noncirrhotic Patients. Hepatogastroenterology. 2003 May-Jun;50(51):784-8. PubMed PMID: 12828085.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Results of modified Sugiura operation in variceal bleeding in cirrhotic and noncirrhotic patients. AU - Haciyanli,Mehmet, AU - Genc,Hudai, AU - Halici,Hakan, AU - Kumkumoglu,Yusuf, AU - Gur,Ozlem S, AU - Ozturk,Tuncay, PY - 2003/6/28/pubmed PY - 2003/10/24/medline PY - 2003/6/28/entrez SP - 784 EP - 8 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 50 IS - 51 N2 - BACKGROUND/AIMS: Esophageal variceal bleeding is a major complication of portal hypertension and the optimal therapeutic modality for each individual patient differs. We reviewed the results of modified Sugiura procedure in patients with variceal bleeding of esophagus. METHODOLOGY: We retrospectively reviewed the charts of 13 patients who were subjected to modified Sugiura procedure (transabdominal esophagogastric devascularization + esophageal stapled transection + splenectomy) for bleeding esophageal varices between 1996 and 2001. Three patients disappeared from routine follow-up and were excluded from the study. Survival, rebleeding and encephalopathy were evaluated. RESULTS: The mean age was 46 (18-56). The etiology of portal hypertension was cirrhosis of liver in six (60%) and portal vein thrombosis in four (40%). One patient had Child-Pugh's Class A, two had Class B and three had Class C cirrhosis. Previous variceal bleeding were confirmed by endoscopy in all patients who had recurrent variceal bleeding despite treatment with beta-blockers (three patients) or endoscopic sclerotherapy +/- band ligation (seven patients). Two were subjected to emergency surgery while the remaining eight were operated on electively. No postoperative mortality was seen. The bleeders were stopped immediately in the emergent cases. During a mean follow-up of 27 (4-53) months, one (10%) patient suffered from encephalopathy and one (10%) from rebleeding at 20th and 28th months after the operation respectively. Three (30%) patients with Child C cirrhosis died due to bleeding (one) and hepatic failure (two) at 4, 25, and 28 months after the surgery. The prognoses of other patients are well at the present time. CONCLUSIONS: In our small number of patients, modified Sugiura procedure was found to be a safe and effective procedure for urgent and long-term control of bleeding varices in patients with portal hypertension due to cirrhosis and noncirrhotic etiology. The outcomes are encouraging in noncirrhotic patients and cirrhotic patients with good liver functions. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/12828085/Results_of_modified_Sugiura_operation_in_variceal_bleeding_in_cirrhotic_and_noncirrhotic_patients_ L2 - https://medlineplus.gov/cirrhosis.html DB - PRIME DP - Unbound Medicine ER -