An assessment of surgery for portal hypertensive patients performed at a single community hospital.
OBJECTIVE
The outcomes of surgery for portal hypertensive patients at a single community hospital in the last two decades were retrospectively examined.


METHODS
From June 1989 to March 2008, 13 of 848 (1.5%) portal hypertensive patients admitted and treated at the community hospital underwent surgery. The types of surgery performed were a distal splenorenal shunt for 2 patients, gastric devascularization and splenectomy for 8, laparoscopic gastric devascularization and splenectomy for 1, distal gastrectomy for 1, and splenectomy alone for 1. This study reviewed the postoperative records of the endoscopic findings and additional treatments, and the perioperative records.


RESULTS
No patient had bleeding from esophagogastric varices during the 75-month mean follow-up period after surgery. Five patients had one or two series of endoscopic treatment for recurrent likely-to-bleed esophageal varices. One patient needed interventional radiology for recurrent gastric varices. No patients died due to upper gastrointestinal bleeding. The survival rates were 87.5% after 5 years and 46.9% after 10 years.


CONCLUSIONS
Surgery for portal hypertensive patients performed at a single community hospital is still safe and effective, and has been adequately incorporated into the late treatment strategy for portal hypertensive patients.
Tomikawa
Morimasa
M
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Akahoshi
Tomohiko
T
Sugimachi
Keishi
K
Ikeda
Yasuharu
Y
Korenaga
Daisuke
D
Takenaka
Kenji
K
Hashizume
Makoto
M
Maehara
Yoshihiko
Y
D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006764:Hospitals, Community; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy; D013164:Splenorenal Shunt, Surgical; D013270:Stomach / Q000098:blood supply / Q000601:surgery; D016896:Treatment Outcome