Cystic fibrosis and portal hypertension interest of partial splenectomy.
Extra pulmonary complications can be major in patients suffering of cystic fibrosis who survive long enough without pulmonary problems. Hepatic cirrhosis is often present and is responsible for portal hypertension with splenomegaly, hypersplenism and esophageal varices. In six patients we have performed a partial splenectomy with conservation of the upper pole of the spleen vascularized by gastrosplenic omentum and its vessels. The post-operative complications (3 scar ruptures but no pulmonary decompensation) are not very important considering the benefits: Normal spleen according to clinical, ultrasonic examination and scintigraphy Correction of hypersplenism Diminution of esophageal varices Stability of hepatic functions. With a post-operative follow-up between 2.5 and 7 years, none of the patients had an increased risk of infection. This technique allows a good survival for those patients waiting for pulmonary transplantation.
Louis
D
D
Hôpital Debrousse, Lyon, France.
Chazalette
J P
JP
D000293:Adolescent; D000328:Adult; D002648:Child; D003550:Cystic Fibrosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006971:Hypersplenism / Q000503:physiopathology / Q000601:surgery; D006975:Hypertension, Portal / Q000503:physiopathology / Q000601:surgery*; D008111:Liver Function Tests; D008297:Male; D013152:Splanchnic Circulation / Q000502:physiology; D013156:Splenectomy