Angiographic evaluation after portal blood flow preserving operations.
We carried out a prospective study comparing postoperative portal angiographic characteristics in patients with hemorrhagic portal hypertension treated electively by two different portal blood flow preserving procedures. Between 1986 and 1991, a total of 81 patients underwent operation: 38 selective shunts and 43 Sugiura-Futagawa procedures. Cirrhosis was shown by biopsy in 50 cases, 26 of them secondary to alcoholism. We found rebleeding in 5% of the patients, incapacitating postoperative encephalopathy in 8%, and an operative mortality of 7%. Fifty-two cases were evaluated in the postoperative period with angiography; 21 patients treated with a Sugiura-Futagawa operation were excluded due to portal vein thrombosis shown in the preoperative studies. Postoperative portal vein thrombosis was found in 11 cases (21%) [seven cases in the Warren group (21%) and four cases in the Sugiura-Futagawa group (20%)]. Decreased portal vein diameter was seen in eight cases (15%). The two procedures maintained hepatopedal portal blood flow, and no change was seen in relation to the preoperative state in 66% of the operated patients. We found no significant differences between the two procedures. Selection of procedure depends on the individual characteristics of each patient.
Mercado
M A
MA
Department of Surgery, Instituto Nacional de la Nutrición, México, D.F. México.
Takahashi
T
T
Rojas
G
G
Prado
E
E
Hernández-Ortiz
J
J
Chan
C
C
Tielve
M
M
Orozco
H
H
D000328:Adult; D000792:Angiography; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000601:surgery*; D008875:Middle Aged; D011168:Portal System / Q000000981:diagnostic imaging*; D011169:Portal Vein; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects; D011184:Postoperative Period; D011446:Prospective Studies; D013927:Thrombosis / Q000209:etiology