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[Azygo-portal disconnection for hemorrhagic cirrhosis. Results and value of abdominal and thoracic approach apropos of 20 cases].
Chirurgie. 1992; 118(4):244-50; discussion 250-1.C

Abstract

The authors report about the results of 20 azygoportal deconnections for the treatment of hemorrhagic cirrhosis caused by the rupture of esophageal or cardiotuberosal varices. All patients had an ethylic cirrhosis of Child-Pugh classes A (1), B (15) or C (4). All had a contraindication to calibrated laterolateral portocaval shunting. Azygoportal deconnection was performed with a thoracic approach in 7 cases, using a Bérard eso-clip in 6 cases and a Prioton button in 1. In 13 cases the approach was abdominal, using EEA circular mechanical clamps. In this cases, trunk vagotomy was performed in 12 cases, in association with pyloroplasty in 10 cases and gastroenteroanastomosis in 2 cases. Splenectomy was performed in 3 patients and the ligation of the splenic artery in a 4th patient. Mortality at 2 months is of 30%, the 6 deaths being caused by hepatic insufficiency in 3 cases, heart and esophageal fistula after an eso-clip was laid in 1 case. The two patients with chronic ascites died of hepatic insufficiency. Mortality at 2 months is of 23% for patients operated in an elective period, and 43% for semiergent operations. Twenty-six percent of the Child B patients and 50% of the Child C patients died. The percentage of residual varices is 57% in the surviving patients. Every second patient had complementary sclerosis. All had had azygoportal deconnection with mechanical clamps. Bleeding recurred in 2 patients (16.6%). Survival is 50% at 1 year and 39% at 3 years.

Authors+Show Affiliations

CHU Saint-Etienne, Hôpital Bellevue, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

fre

PubMed ID

1339736

Citation

Balique, J G., et al. "[Azygo-portal Disconnection for Hemorrhagic Cirrhosis. Results and Value of Abdominal and Thoracic Approach Apropos of 20 Cases]." Chirurgie; Memoires De l'Academie De Chirurgie, vol. 118, no. 4, 1992, pp. 244-50; discussion 250-1.
Balique JG, Gangner Y, Porcheron J, et al. [Azygo-portal disconnection for hemorrhagic cirrhosis. Results and value of abdominal and thoracic approach apropos of 20 cases]. Chirurgie. 1992;118(4):244-50; discussion 250-1.
Balique, J. G., Gangner, Y., Porcheron, J., Cadi, F., Sangare, D., Marchand, A., Peng, J., Chabert, M., & Ludot, T. (1992). [Azygo-portal disconnection for hemorrhagic cirrhosis. Results and value of abdominal and thoracic approach apropos of 20 cases]. Chirurgie; Memoires De l'Academie De Chirurgie, 118(4), 244-50; discussion 250-1.
Balique JG, et al. [Azygo-portal Disconnection for Hemorrhagic Cirrhosis. Results and Value of Abdominal and Thoracic Approach Apropos of 20 Cases]. Chirurgie. 1992;118(4):244-50; discussion 250-1. PubMed PMID: 1339736.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Azygo-portal disconnection for hemorrhagic cirrhosis. Results and value of abdominal and thoracic approach apropos of 20 cases]. AU - Balique,J G, AU - Gangner,Y, AU - Porcheron,J, AU - Cadi,F, AU - Sangare,D, AU - Marchand,A, AU - Peng,J, AU - Chabert,M, AU - Ludot,T, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 244-50; discussion 250-1 JF - Chirurgie; memoires de l'Academie de chirurgie JO - Chirurgie VL - 118 IS - 4 N2 - The authors report about the results of 20 azygoportal deconnections for the treatment of hemorrhagic cirrhosis caused by the rupture of esophageal or cardiotuberosal varices. All patients had an ethylic cirrhosis of Child-Pugh classes A (1), B (15) or C (4). All had a contraindication to calibrated laterolateral portocaval shunting. Azygoportal deconnection was performed with a thoracic approach in 7 cases, using a Bérard eso-clip in 6 cases and a Prioton button in 1. In 13 cases the approach was abdominal, using EEA circular mechanical clamps. In this cases, trunk vagotomy was performed in 12 cases, in association with pyloroplasty in 10 cases and gastroenteroanastomosis in 2 cases. Splenectomy was performed in 3 patients and the ligation of the splenic artery in a 4th patient. Mortality at 2 months is of 30%, the 6 deaths being caused by hepatic insufficiency in 3 cases, heart and esophageal fistula after an eso-clip was laid in 1 case. The two patients with chronic ascites died of hepatic insufficiency. Mortality at 2 months is of 23% for patients operated in an elective period, and 43% for semiergent operations. Twenty-six percent of the Child B patients and 50% of the Child C patients died. The percentage of residual varices is 57% in the surviving patients. Every second patient had complementary sclerosis. All had had azygoportal deconnection with mechanical clamps. Bleeding recurred in 2 patients (16.6%). Survival is 50% at 1 year and 39% at 3 years. SN - 0001-4001 UR - https://www.unboundmedicine.com/medline/citation/1339736/[Azygo_portal_disconnection_for_hemorrhagic_cirrhosis__Results_and_value_of_abdominal_and_thoracic_approach_apropos_of_20_cases]_ L2 - http://RD3FS2PT9J.search.serialssolutions.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqm&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&genre=article&issn=0001-4001&eissn=&volume=118&issue=4&spage=244&date=1992 DB - PRIME DP - Unbound Medicine ER -