Survival and quality of life after portal blood flow preserving procedures in patients with portal hypertension and liver cirrhosis.
Between 1979 and 1991, 156 patients with histologically proven liver cirrhosis, good liver function, and bleeding portal hypertension underwent operation with portal blood flow preserving procedures (selective shunts: 101; Sugiura-Futagawa: 55). Long-term results of the procedures and the quality of life of the 145 patients who survived the operation were studied. During the observation period (range 3 to 156 months), 28 patients died. The main causes of death were liver failure and hepatoma. Twenty-three patients were lost for follow-up. Twenty-six patients (18%) developed 1 or more encephalopathic episodes. Four patients (3%) experienced rebleeding. One hundred eight patients (74%) had a good quality of life, and 26 (18%) had a poor quality of life. Eleven (15%) of 73 patients with a history of alcoholism continued drinking. Five-year survival for the selective shunt group was 81% and for the devascularization group was 83%. In 81% of the patients, portal blood flow was maintained. It is concluded that both procedures are effective in the long-term. Most patients are able to rehabilitate from the use of alcohol, and most of them have a good quality of life. For patients with good liver function (whose main problem is bleeding), surgery is the best choice of treatment.
Orozco
H
H
Portal Hypertension Clinic, Instituto Nacional de la Nutricion, Tlalpan, Mexico, D.F., Mexico.
Mercado
M A
MA
Takahashi
T
T
Rojas
G
G
Hernández
J
J
Tielve
M
M
D000328:Adult; D000368:Aged; D001775:Blood Circulation; D002423:Cause of Death; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011168:Portal System; D011170:Portasystemic Shunt, Surgical / Q000145:classification / Q000379:methods*; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index; D015996:Survival Rate