Management strategy for gastric cancer with liver cirrhotic portal hypertension

VernacularTitle:胃癌合并肝硬化门静脉高压症的手术疗效评估
Author: Ming PAN ; Guangwen ZHOU
Publication Type:Journal Article
Keywords: Stomach neoplasms; Liver cirrhosis; Hypertension,portal
From: Chinese Journal of General Surgery 2011;26(8):674-676
CountryChina
Language:Chinese
Abstract: Objective To assess the concurrent management for portal hypertension (PHT) in gastric cancer patients. Methods Retrospective analysis was made on 60 cases of gastric cancer occurring on the background of cirrhotic PHT, of which 30 cases were of Child A grade, and 30 patients were Child B class. Ten cases were on gastric cancer stage Ⅰ , 38 cases on stage Ⅱ and 12 cases were on stage Ⅲ.Radical gastrectomy plus splenectomy and devascularization were performed in 26 cases, while radical gastrectomy only was done in 34 cases. Results Postoperative Child-Pugh degrading developed in 100% cases undergoing combined procedures; while in the 34 cases undergoing radical gastrectomy only,postoperative degradation from the preoperative Child-Pugh classification occurred in 7 cases ( 20% ), P ＜0. 001. In this series the peri-operative mortality was 3%, all were patients at stage Ⅲ gastric cancer combined with Child-Pugh class B. Conclusions The principle of treatment for gastric cancer with cirrhotic portal hypertension is restrictive surgery. The main purpose is to cure cancer and not to damage liver function.