Surgical treatment of postoperative rebleeding in portal hypertension.
- VernacularTitle:门静脉高压症术后再出血的外科治疗
- Author:
Yu WANG
;
Qi ZHENG
;
Qingtian LIN
- Publication Type:Journal Article
- From:
Chinese Journal of Practical Surgery
2001;21(3):142-144
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate the effect of different operative methods for treating rebleeding in patients with portal hypertension(PHT). MethodsThe clinical data of 66 patients with postoperative ebleeding out of 373 PHT cases during the last 30 years was retrospectively analyzed. Their first operations were splenectomy, portoazygous devascularization, various non-selective shunt and combined operation(devascularization combined with shunt), of which, the rebleeding rate were 26.67 %, 17.86 %, 14.58 % and 4.35 %, respectively. Among 55 cases receiving re-operation, there were 42 with distal esophago-fundusectomy, 11 mesocaval shunt(MCS)and 2 re-devascularization. The other 11 cases received nonoperative therapy. ResultsThe mortality, mean follow-up time, rebleeding rate and encephalopathy rate were 9.52% (4/42), 11 years,9.52% (4/42)and 14.29% (6/42)in distal esophago-fundusectomy group;0,7.5 years,0 and 9.09% (1/11)in MCS group. All 2 cases in re-devascularization group died within one postoperative month. All 11 cases in non-operative group were with portal hypertension gastropathy(PHG). ConelusionCombined operation may effectively reduce postoperative rebleeding rate in PHT cases and MCS is a relatively ideal method for treating rebleeding.
