Document Detail


Salvage surgery in variceal bleeding due to portal hypertension.
MedLine Citation:
PMID:  17401228     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A proportion (10%-15%) of patients with variceal bleeding do not respond to medical management and require surgical intervention. METHODS: Retrospective analysis of 82 consecutive patients (median age 31 years, range 3-71; 60 male) who underwent salvage surgery for variceal bleeding between 1989 and 2005. RESULTS: Immediate control of variceal bleeding was achieved in 78 (95%) patients. Four patients (cirrhosis 3, portal vein block 1) continued to bleed in the postoperative period following gastro-esophageal devascularization (3) or portacaval shunt (1). Twelve (15%) patients died in hospital; the commonest cause of death (n=7) was liver failure and sepsis leading to multi-system organ failure. The mortality rate was higher among patients who had undergone emergency surgery for active bleeding than among those who had been adequately resuscitated and evaluated prior to surgery (12/45 vs. 0/37; p< 0.001). Mortality rate tended to be higher in patients with cirrhosis (overall 10/45 [22%]; Child A 1/9 [11%], Child B 4/20 [20%], Child C 5/16 [31%]) than in those with non-cirrhotic portal hypertension (3/37 [8%]; p=ns). CONCLUSIONS: Our data suggest that salvage surgery is justified in patients with variceal bleed in whom non-surgical measures fail.
Authors:
Ajay Sharma; Paari Vijayaraghavan; Richa Lal; Anu Behari; Ashok Kumar; Sadiq S Sikora; Rajan Saxena; Vinay K Kapoor
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology     Volume:  26     ISSN:  0254-8860     ISO Abbreviation:  Indian J Gastroenterol     Publication Date:    2007 Jan-Feb
Date Detail:
Created Date:  2007-04-02     Completed Date:  2007-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8409436     Medline TA:  Indian J Gastroenterol     Country:  India    
Other Details:
Languages:  eng     Pagination:  14-7     Citation Subset:  IM    
Affiliation:
Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226 014, India.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Child, Preschool
Esophageal and Gastric Varices / etiology*,  mortality,  surgery*
Female
Gastrointestinal Hemorrhage / etiology*,  mortality,  surgery*
Humans
Hypertension, Portal / complications*
Male
Middle Aged
Retrospective Studies
Salvage Therapy
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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