Open esophagastric devascularization in recurrent variceal bleeding after endoscopic therapy
10.3760/cma.j.issn.1007-631X.2012.01.002
- VernacularTitle:食管胃底静脉曲张破裂出血内镜治疗失败后再手术
- Author:
Wei QIU
;
Guangyi WANG
;
Meng WANG
;
Guoyue Lü
;
Yahui LIU
;
Xiaodong SUN
- Publication Type:Journal Article
- Keywords:
Esophageal and gastric varices;
Gastrointestinal hemorrhage;
Endoscopy;
Reoperation
- From:
Chinese Journal of General Surgery
2012;27(1):2-4
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effect of naive porto-azygous devascularization and that as a remedy therapy after a failed endoscopy for the treatment of bleeding portal hypertension.Method From June 2005 to June 2010,230 portal hypertension patients were treated with porto-azygous devascularization,among them,202 cases were of portal hypertensive cirrhotics,28 cases of alcoholic cirrhosis.Group A (16 patients)received remedial porto-azygous devascularization after endoscopic treatment failed (esophageal variceal ligation,esophageal variceal selerotherapy).Group B(214 patients)received naive porto-azygous devascularization.Results The average operation time in group A was 198 min(115-335)min,mean bleeding amount was 750 ml(300-2000)ml,average post-operative hospital stay was 11 days (8-15)days.The average operation time in group B was 120 min(90-190)min,mean blood loss was 250 ml(150-500)ml,average post-operative hospital stay was 7 days(6-9)days.The average operation time,bleeding amount and post-operative hospital stay was significantly different between the two groups (P＜ 0.05).212(92.2％)patients were followed up,and the mean follow-up time was 2.5 years (1-6)years,mortality rate was 4.2％,rebleeding rate was 5.7％.Conclusions Surrounding the perioesophageal and gastric tissues were fibrotic and hard after the endoscopic treatment,this significantly increased the difficulty of surgery,therefore,porto-azygous devascularization is the choice of therapy for portal hypertension patients.
