Document Detail


Triplex operation for portal hypertension with esophageal variceal bleeding: report of 140 cases.
MedLine Citation:
PMID:  15567740     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Portal hypertension is a common disease. The surgical therapy of this disease focuses on the resultant upper digestive tract bleeding, which can imperil patients' life directly. This study was to evaluate the effect of triplex operation (mesocaval C shunt with artificial graft, ligation of the coronary vein and splenic artery) on portal hypertension and its associated upper digestive tract bleeding. METHODS: A retrospective study was made on clinical data of 140 patients undergoing triplex operation, who had suffered from portal hypertension and upper digestive tract bleeding. RESULTS: Postoperative portal pressure was 25-43 cmH2O(preoperative portal pressure 27-45 cmH2O) with the average reduction of 10 cmH2O. One patient (0.7%) died of cerebrovascular disease. Five patients (3.5%) suffered from mild hepatic encephalopathy, which was ameliorated through conservative treatment. Lymphatic fistula occurred in 3 patients (2.1%) who recovered without treatment 5, 10 days and 3 months after operation respectively. One hundred patients were followed up for 1 month to 6 years without recurrent hemorrhage or hepatic encephalopathy. Hypersplenism and ascites disappeared in 70 patients (70%) and 80 patients (80%) respectively. A significant reduction of ascites was seen in 12 patients(12%). The artificial vessels remained unblocking detected by B type ultrasonography and Doppler sonography in 95 patients(95%). CONCLUSION: Triplex operation is suitable for patients with the following portal hypertensions: portal hypertension caused by simple occlusion of the hepatic vein (a pathological type of Budd-Chiari syndrome); thrombosis of the portal vein or prehepatic portal hypertension because of cavernous transformation; intrahepatic portal hypertension with rebleeding after splenectomy or non-operation, and those patients with liver function in grade A or B according to the Child-Pugh classification.
Authors:
Liu-Shun Feng; Ke Li; Qi-Ping Peng; Xiu-Xian Ma; Yong-Fu Zhao; Pei-Qin Xu; Xiao-Ping Chen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepatobiliary & pancreatic diseases international : HBPD INT     Volume:  3     ISSN:  1499-3872     ISO Abbreviation:  HBPD INT     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-29     Completed Date:  2005-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101151457     Medline TA:  Hepatobiliary Pancreat Dis Int     Country:  China    
Other Details:
Languages:  eng     Pagination:  534-7     Citation Subset:  IM    
Affiliation:
Department of General Surgery, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Vessel Prosthesis
Coronary Vessels / surgery
Esophageal and Gastric Varices / etiology*,  surgery*
Female
Gastrointestinal Hemorrhage / etiology*,  surgery
Humans
Hypertension, Portal / complications*,  surgery*
Ligation
Male
Middle Aged
Portasystemic Shunt, Surgical / adverse effects
Retrospective Studies
Splenic Artery / surgery
Veins / surgery

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


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