2014Zhonghua putong waike zazhiRequires access

Esophagofundostomy in combination with esophagogastric devascularization for the treatment of portal hypertension

Zhiyong Wang, Junjing Zhang, Jianliang Qiao, Xingkai Meng

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Abstract

Objective To evaluate the effect of esophagofundostomy combined with devascularization for the treatment of portal hypertension.Methods From February 2009 to August 2013,30 cases (research group) underwent esophagofundostomy combined with devascularization,while 56 cases (control group) were treated by devascularization only.Splenectomy was performed in all patients.Results There was no perioperative mortality in either group.The difference of postoperative serum bilirubin,albumin and blood platelet was not statistically significant (t =1.13、0.23、1.53,all P > 0.05) ; The incidence of hepatic encephalopathy in research group and control group was 3% and 11%,respectively,three years mortality was 14% and 24%,respectively (x2 =0.61、1.22,all P >0.05).The rebleeding rate in research group was lower than control group,there was a significant difference (x2 =4.61,P < 0.05).Research group was superior to control group in improving esophageal-gastric varices and there was a significant difference (P < 0.05).Conclusions Compared with devascularization,esophagofundostomy combined with devascularization is more effective in reducing esophageal-gastric varices and prevention of rebleeding. Key words: Hypretension, portal;  Anastomosis, surgical;  Esophageal and gastric varices ; Devascularization

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What this paper is about

Objective To evaluate the effect of esophagofundostomy combined with devascularization for the treatment of portal hypertension.Methods From February 2009 to August 2013,30 cases (research group) underwent esophagofundostomy combined with devascularization,while 56 cases (control group) were treated by devascularization only.Splenectomy was performed in all patients.Results There was no perioperative mortality in either group.The difference of postoperative serum bilirubin,albumin and blood platelet was not statistically significant (t =1.13、0.23、1.53,all P > 0.05) ; The incidence of hepatic encephalopathy in research group and control group was 3% and 11%,respectively,three years mortality was 14% and 24%,respectively (x2 =0.61、1.22,all P >0.05).The rebleeding rate in research group was lower than control group,there was a significant difference (x2 =4.61,P < 0.05).Research group was superior to control group in improving esophageal-gastric varices and there was a significant difference (P < 0.05).Conclusions Compared with devascularization,esophagofundostomy combined with devascularization is more effective in reducing esophageal-gastric varices and prevention of rebleeding. Key words: Hypretension, portal;  Anastomosis, surgical;  Esophageal and gastric varices ; Devascularization

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Available abstract

Objective To evaluate the effect of esophagofundostomy combined with devascularization for the treatment of portal hypertension.Methods From February 2009 to August 2013,30 cases (research group) underwent esophagofundostomy combined with devascularization,while 56 cases (control group) were treated by devascularization only.Splenectomy was performed in all patients.Results There was no perioperative mortality in either group.The difference of postoperative serum bilirubin,albumin and blood platelet was not statistically significant (t =1.13、0.23、1.53,all P > 0.05) ; The incidence of hepatic encephalopathy in research group and control group was 3% and 11%,respectively,three years mortality was 14% and 24%,respectively (x2 =0.61、1.22,all P >0.05).The rebleeding rate in research group was lower than control group,there was a significant difference (x2 =4.61,P < 0.05).Research group was superior to control group in improving esophageal-gastric varices and there was a significant difference (P < 0.05).Conclusions Compared with devascularization,esophagofundostomy combined with devascularization is more effective in reducing esophageal-gastric varices and prevention of rebleeding. Key words: Hypretension, portal;  Anastomosis, surgical;  Esophageal and gastric varices ; Devascularization

Key concepts: Medicine, Portal hypertension, Esophageal varices, Splenectomy, Gastric varices, Gastroenterology, Internal medicine, Perioperative

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