Proximal Splenorenal Shunt Surgery for Bleeding Gastric Varices in Non-Cirrhotic Portal Hypertension.
gastric varices
non cirrhotic portal hypertension
proximal splenorenal shunt
secondary prophylaxis
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
15 Sep 2020
15 Sep 2020
Historique:
entrez:
21
10
2020
pubmed:
22
10
2020
medline:
22
10
2020
Statut:
epublish
Résumé
Background The optimal management of gastric variceal bleeding in patients with non-cirrhotic portal hypertension (NCPH) is debatable due to the lack of data from large randomized controlled trials. Here we present our experience on proximal splenorenal shunt (PSRS) surgery in NCPH patients with bleeding gastric varices. Methods Over a five-year period, a total of 25 PSRS surgeries were performed and data was collected prospectively. Nineteen extrahepatic portal vein obstruction (EHPVO) and six non-cirrhotic portal fibrosis (NCPF) patients with bleeding fundic or isolated gastric varices and normal liver function were included. The collected data was analyzed retrospectively. Results Of the 25 patients who underwent PSRS five were lost to follow-up. Twenty patients (80%) were followed up for a median of 3.4 (1-5) years. Gastric variceal regression was noted in all 20 patients with the disappearance of varices in eight patients. On follow-up, shunt thrombosis was noted in four (20%) patients of whom, two had rebleeding between six months and three years after shunt surgery. Conclusion PSRS was effective in controlling gastric variceal hemorrhage in 92% (23 of 25) of patients with preserved liver function.
Identifiants
pubmed: 33083167
doi: 10.7759/cureus.10464
pmc: PMC7566982
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e10464Informations de copyright
Copyright © 2020, Anand et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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