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. 2017 Jun 8:23:2788-2795.
doi: 10.12659/msm.904660.

Retrospective Study to Compare Selective Decongestive Devascularization and Gastrosplenic Shunt versus Splenectomy with Pericardial Devascularization for the Treatment of Patients with Esophagogastric Varices Due to Cirrhotic Portal Hypertension

Haili Bao  1 , Qikuan He  1 , Ninggao Dai  1 , Ruifan Ye  1 , Qiyu Zhang  1
Affiliations

Retrospective Study to Compare Selective Decongestive Devascularization and Gastrosplenic Shunt versus Splenectomy with Pericardial Devascularization for the Treatment of Patients with Esophagogastric Varices Due to Cirrhotic Portal Hypertension

Haili Bao et al. Med Sci Monit. .

Abstract

BACKGROUND For patients with esophagogastric varices secondary to portal hypertension due to liver cirrhosis, portosystemic shunts and devascularization have become the most commonly used treatment methods. We have developed a novel surgical approach for the treatment of patients with cirrhotic portal hypertension, selective decongestive devascularization, and shunt of the gastrosplenic region (SDDS-GSR). This aim of this study was to compare the efficacy and safety of SDDS-GSR with splenectomy with pericardial devascularization (SPD). MATERIAL AND METHODS A retrospective study was undertaken between 2006 and 2013 and included 110 patients with cirrhotic portal hypertension, 34 of whom underwent SDDS-GSR; 76 patients underwent SPD. Kaplan-Meier analysis was used to evaluate clinical outcomes, mortality, the incidence of re-bleeding, encephalopathy, and portal venous system thrombosis (PVST). RESULTS Postoperatively portal venous pressure decreased by 20% in both groups. The long-term incidence of re-bleeding and PVST was significantly lower in the SDDS-GSR group compared with the SPD group (P=0.018 and P=0.039, respectively). CONCLUSIONS This preliminary retrospective study has shown that SDDS-GSR was an effective treatment for patients with esophagogastric varices secondary to portal hypertension that may be used as a first-line treatment to prevent variceal bleeding and lower the incidence of PVST.

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Figures

Figure 1
Figure 1
The coarctation forceps.
Figure 2
Figure 2
The splenic artery coarctated with the artificial artery.
Figure 3
Figure 3
Kaplan-Meier curve for overall survival (OS) rate.
Figure 4
Figure 4
The abdominal magnetic resonance imaging (MRI) before and after selective decongestive devascularization and shunt of the gastrosplenic region (SDDS-GSR).
See this image and copyright information in PMC

References

    1. Henderson JM, Boyer TD, Kutner MH, et al. Distal splenorenal shunt versus transjugular intrahepatic portal systematic shunt for variceal bleeding: A randomized trial. Gastroenterology. 2006;130:1643–51. - PubMed
    1. Wright AS, Rikkers LF. Current management of portal hypertension. J Gastrointest Surg. 2005;9:992–1005. - PubMed
    1. Wu J, Li Z, Wang Z, et al. Surgical and endovascular treatment of severe complications secondary to noncirrhotic portal hypertension: Experience of 56 cases. Ann Vasc Surg. 2013;27:441–46. - PubMed
    1. Lima Kde M, Negro-Dellacqua M, Dos Santos VE, et al. Post-splenectomy infections in chronic schistosomiasis as a consequence of bacterial translocation. Rev Soc Bras Med Trop. 2015;48:314–20. - PubMed
    1. Cheng Z, Li JW, Chen J, et al. Therapeutic effects of laparoscopic splenectomy and esophagogastric devascularization on liver cirrhosis and portal hypertension in 204 cases. J Laparoendosc Adv Sur Tech A. 2014;24:612–16. - PubMed

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