Tags

Type your tag names separated by a space and hit enter

Effects of modified splenocaval shunt plus devascularization on esophagogastric variceal bleeding: a comparative study of this treatment and devascularization only in cirrhotic portal hypertension.
J Hepatobiliary Pancreat Sci. 2010 Sep; 17(5):657-65.JH

Abstract

BACKGROUND

Pericardial devascularization (PCDV) and portosystemic shunt were reported to have favorable results for the management of portal hypertension in cirrhotic patients in China and the West, respectively. This study was undertaken to investigate the effects of a modified proximal splenocaval shunt plus PCDV on variceal bleeding in patients with portal hypertension.

METHODS

From January 1997 to December 2007, 168 patients with portal hypertension of cirrhotic origin received an operation for gastroesophageal variceal bleeding. Of these, 90 patients received a splenocaval shunt plus a PCDV procedure (Combined Group) and the other 78 patients received a PCDV procedure only (PCDV Group). The procedure-related morbidity and mortality, rebleeding, encephalopathy, and survival rates were analyzed.

RESULTS

Postoperative mortality was 3.3% in the combined group and 5.1% in the PCDV group (P > 0.05). Overall morbidity was 13.3% in the combined group and 15.4% in the PCDV group (P > 0.05). The rate for rebleeding, including variceal bleeding and gastropathy, was 5.1% in the combined group, which was significantly lower than that in the PCDV group, at 16.7% (P < 0.05). The incidence of encephalopathy was 6.63% in the combined group and 6.67% in the PCDV group (P > 0.05). The 1-, 3-, 5- and 10-year survival rates were 97.4, 91.7, 80.0, and 60.0% in the combined group and 96.7, 83.3, 73.3, and 53.3% in the PCDV group (P > 0.05).

CONCLUSIONS

The modified splenocaval shunt plus PCDV is a safe and effective procedure for the long-term control of variceal bleeding; the procedure may not only maintain the portal flow to the liver, but may also protect the liver function in cirrhotic patients. The better clinical outcome means that the procedure may be one of the best choices for treating portal hypertension of cirrhotic origin.

Authors+Show Affiliations

Department of Hepatobiliary Surgery, The Third Affiliated Hospital, Medical College of Xi'an Jiaotong University, Shaanxi Provincial People's Hospital, No. 256, Youyi West Road, Xi'an, 710068, China. lixuedu_xa@163.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20703844

Citation

Du, Lixue, et al. "Effects of Modified Splenocaval Shunt Plus Devascularization On Esophagogastric Variceal Bleeding: a Comparative Study of This Treatment and Devascularization Only in Cirrhotic Portal Hypertension." Journal of Hepato-biliary-pancreatic Sciences, vol. 17, no. 5, 2010, pp. 657-65.
Du L, Wu W, Zhang Y, et al. Effects of modified splenocaval shunt plus devascularization on esophagogastric variceal bleeding: a comparative study of this treatment and devascularization only in cirrhotic portal hypertension. J Hepatobiliary Pancreat Sci. 2010;17(5):657-65.
Du, L., Wu, W., Zhang, Y., Sun, Z., Hu, H., Liu, X., & Liu, Q. (2010). Effects of modified splenocaval shunt plus devascularization on esophagogastric variceal bleeding: a comparative study of this treatment and devascularization only in cirrhotic portal hypertension. Journal of Hepato-biliary-pancreatic Sciences, 17(5), 657-65. https://doi.org/10.1007/s00534-010-0262-8
Du L, et al. Effects of Modified Splenocaval Shunt Plus Devascularization On Esophagogastric Variceal Bleeding: a Comparative Study of This Treatment and Devascularization Only in Cirrhotic Portal Hypertension. J Hepatobiliary Pancreat Sci. 2010;17(5):657-65. PubMed PMID: 20703844.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of modified splenocaval shunt plus devascularization on esophagogastric variceal bleeding: a comparative study of this treatment and devascularization only in cirrhotic portal hypertension. AU - Du,Lixue, AU - Wu,Wujun, AU - Zhang,Yu, AU - Sun,Zhongjie, AU - Hu,Haitian, AU - Liu,Xiaogang, AU - Liu,Qingguang, Y1 - 2010/03/02/ PY - 2009/10/09/received PY - 2010/01/06/accepted PY - 2010/8/13/entrez PY - 2010/8/13/pubmed PY - 2010/12/17/medline SP - 657 EP - 65 JF - Journal of hepato-biliary-pancreatic sciences JO - J Hepatobiliary Pancreat Sci VL - 17 IS - 5 N2 - BACKGROUND: Pericardial devascularization (PCDV) and portosystemic shunt were reported to have favorable results for the management of portal hypertension in cirrhotic patients in China and the West, respectively. This study was undertaken to investigate the effects of a modified proximal splenocaval shunt plus PCDV on variceal bleeding in patients with portal hypertension. METHODS: From January 1997 to December 2007, 168 patients with portal hypertension of cirrhotic origin received an operation for gastroesophageal variceal bleeding. Of these, 90 patients received a splenocaval shunt plus a PCDV procedure (Combined Group) and the other 78 patients received a PCDV procedure only (PCDV Group). The procedure-related morbidity and mortality, rebleeding, encephalopathy, and survival rates were analyzed. RESULTS: Postoperative mortality was 3.3% in the combined group and 5.1% in the PCDV group (P > 0.05). Overall morbidity was 13.3% in the combined group and 15.4% in the PCDV group (P > 0.05). The rate for rebleeding, including variceal bleeding and gastropathy, was 5.1% in the combined group, which was significantly lower than that in the PCDV group, at 16.7% (P < 0.05). The incidence of encephalopathy was 6.63% in the combined group and 6.67% in the PCDV group (P > 0.05). The 1-, 3-, 5- and 10-year survival rates were 97.4, 91.7, 80.0, and 60.0% in the combined group and 96.7, 83.3, 73.3, and 53.3% in the PCDV group (P > 0.05). CONCLUSIONS: The modified splenocaval shunt plus PCDV is a safe and effective procedure for the long-term control of variceal bleeding; the procedure may not only maintain the portal flow to the liver, but may also protect the liver function in cirrhotic patients. The better clinical outcome means that the procedure may be one of the best choices for treating portal hypertension of cirrhotic origin. SN - 1868-6982 UR - https://www.unboundmedicine.com/medline/citation/20703844/Effects_of_modified_splenocaval_shunt_plus_devascularization_on_esophagogastric_variceal_bleeding:_a_comparative_study_of_this_treatment_and_devascularization_only_in_cirrhotic_portal_hypertension_ L2 - https://doi.org/10.1007/s00534-010-0262-8 DB - PRIME DP - Unbound Medicine ER -