[Current indications and results of elective truncal portacaval shunt. Apropos of 97 cases].
The authors analyse the results of a series of 97 cases of elective porto-caval anastomoses for ruptured oesophageal varices and compare them with those of the literature. Elective porto-caval anastomosis satisfactorily prevents haemorrhagic recurrence (3%) at the cost of an operative mortality of 10% (nil over the last five years). Porto-caval encephalopathy was observed in 36% of cases with an incapacitating form (stage II or III) in 21% of operated patients and always represented the major disadvantage of surgery. However, the place of truncal porto-caval anastomosis is still intact in the prevention of recurrent haemorrhage from ruptured oesophageal varices. Warren's operation, the reference surgical technique, cannot be performed systematically because of technical reasons and/or because of rigorous selection. Endoscopic sclerotherapy represents a fundamental therapeutic procedure during the haemorrhagic period. Permanent haemostasis is more difficult to obtain and requires surgery in about 25% of cases. The mortality and morbidity associated with the endoscopic method are compared with the surgical results in two series of patients belonging to Child's groups A and B.
Assadourian
R
R
Service de Chirurgie Générale et Digestive, Hôtel-Dieu, Marseille.
Abitbol
A
A
Berthet
B
B
D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006501:Hepatic Encephalopathy / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical / Q000009:adverse effects / Q000379:methods* / Q000401:mortality
Indications actuelles et résultats de l'anastomose porto-cave tronculaire en période élective. A propos of 97 observations.