[Predictive factors of rebleeding in cirrhotic patients submitted to Warren's surgery].
BACKGROUND
Establish the predictive factors of rebleeding in cirrhotic patients submitted to the Warren's surgery.


METHODS
57 cirrhotic patients with good hepatic functional reserve and previous variceal bleeding that had not responded to clinical, endoscopic treatment were submitted to the Warren's surgery (distal splenorenal shunt). They were divided in two groups: I (31 had presented rebleeding at postoperative care) and II (26 had not presented new bleeding). Group I was again divided into 2 groups according to time of rebleeding: Group I.A (12 that presented rebleeding until hospital discharge) and Group I.B (19 that presented rebleeding after hospital discharge). We analyzed the clinical, endoscopic, laboratorial and Doppler-ultrasound information at the pre- and postoperative moments and also intrasurgery data that were compared between the established groups.


RESULTS
Serum albumin and bilirubins were 3.33 mg% and 1.7 mg% in group I, 3.56 mg% and 1.16 mg% in group II. Portal flow and diameter were 0.24 cm/s and 1.34 cm in group I, and 0.18 cm/s and 1.21 cm in group II, respectively. In group I.A the volume of crystalloid given during surgery was 3.692 ml against 2.166 ml in group I.B.


CONCLUSIONS
Albumin and total bilirubins dosages in the preoperative period, added to the value of the flow and portal diameter were predictive factors for rebleeding in cirrhotic patients submitted to the Warren's surgery. The volume of crystalloid given during the surgery was a predictive factor for early rebleeding.
Ferreira
Fabio Gonçalves
FG
Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP.
Saliture Neto
Fernando Tavares
FT
Santos
Maria de Fátima
Mde F
Assef
José Cesar
JC
Szutan
Luiz Arnaldo
LA
De Capua Junior
Armando
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000150:complications* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012008:Recurrence; D012189:Retrospective Studies; D013164:Splenorenal Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D017211:Treatment Failure