Long-term prognosis of non-shunt operation for idiopathic portal hypertension.
This report presents 46 Japanese patients with idiopathic portal hypertension (IPH) in whom non-shunt operation was performed for the management of esophageal varices. Non-shunt operation included transthoracic esophageal transection (Sugiura's procedure) in 37 patients, transabdominal esophageal transection (TAET) in 3 patients, and Hassab's procedure in 6 patients. Rates of postoperative variceal eradication were: 78.4% by Sugiura's procedure; 100% by TAET; and 50% by Hassab's procedure. The cumulative rates for recurrent varices and recurrent bleeding were 3.9%, and 5.1%, respectively, at 5 years, and 8.9% and 9.8% at both 10 and 15 years. Only 3 patients required additional endoscopic injection sclerotherapy to treat recurrent varices. Although 3 patients developed upper gastrointestinal bleeding, the source of hemorrhage was esophageal varices in 1, and portal hypertensive gastropathy in 2; none of the patients died from bleeding. Actuarial survival for all patients was 87.5% at 5 years, 77.9% at 10 years, and 58.8% at 15 years. There were no deaths within the first 30 days after surgery. These results show that non-shunt operation is useful in preventing bleeding from esophageal varices in patients with IPH.
Ohashi
K
K
Second Department of Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Kojima
K
K
Fukazawa
M
M
Beppu
T
T
Futagawa
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004932:Esophageal and Gastric Varices / Q000601:surgery; D004947:Esophagus / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000401:mortality / Q000601:surgery*; D008297:Male; D008722:Methods; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D015911:Sclerotherapy; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome