Surgical Management of Extrahepatic Portal Hypertension and Variceal Bleeding

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 1994 Mar 1

PMID 8042330

Citations 8

Authors

H Orozco

T Takahashi

M A Mercado

E Prado

C Chan

Affiliations

Soon will be listed here.

Abstract

Variceal bleeding remains an important complication in extrahepatic portal vein thrombosis (EPVT). As for portal hypertension due to other etiologies, an elective treatment to decrease the risk of subsequent rebleeding is warranted. The results of the Sugiura-Futagawa procedure (SP) in 38 patients with variceal bleeding secondary to EPVT are reported: 20 women and 18 men, with a mean age of 28 +/- 2 years (SEM). Thirty-seven patients were classified as Child-Pugh class A, and one patient as class B. In terms of diagnosis, 45% of patients had idiopathic EPVT, and 18% had associated hypercoagulability disorders; 52% of patients had associated splenic vein thrombosis. The SP was completed in two surgical stages in 18 patients and in one surgical stage in 14; 6 patients had only the abdominal stage. One patient had mild postoperative encephalopathy, and three patients rebled at long-term follow-up study. There were two operative deaths. Actuarial survival was 70% at 64 months. It is concluded that the SP is an excellent alternative for patients with variceal bleeding secondary to EPVT.

Citing Articles

Comparison of surgical outcomes between shunt surgery and devascularization in non-cirrhotic portal hypertension.

Anwar S, Parasar K, Anand U, Singh B, Kant K, Kodali R Turk J Surg. 2025; 40(3):229-239.

PMID: 39917409 PMC: 11792894. DOI: 10.47717/turkjsurg.2024.6525.

Long-term results of the paraesophagogastric devascularization with or without esophageal transection: which is more suitable for variceal bleeding?.

Zhang H, Li W, Ye H, Xiao Z, Peng Y, Wang J World J Surg. 2014; 38(8):2105-12.

PMID: 24590450 DOI: 10.1007/s00268-014-2478-2.

Two surgical procedures for esophagogastric variceal bleeding in patients with portal hypertension.

Yang L, Yuan L, Dong R, Yin J, Wang Q, Li T World J Gastroenterol. 2014; 19(48):9418-24.

PMID: 24409071 PMC: 3882417. DOI: 10.3748/wjg.v19.i48.9418.

Management of variceal hemorrhage in children with extrahepatic portal venous obstruction-shunt surgery versus endoscopic sclerotherapy.

Wani A, Shah O, Zargar S Indian J Surg. 2012; 73(6):409-13.

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Extrahepatic portal venous obstruction: is the knife irrelevant?.

Pal S, Sahni P Indian J Gastroenterol. 2010; 28(6):198-200.

PMID: 20177866 DOI: 10.1007/s12664-009-0078-0.

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