Fifty cases of portal hypentension with esophageal varices which had undergone sugical operation at Kyung Hee University Hospital during last nine years from January 1981. to December 1989 were reviewed retrospectively.
Male to female ratio of the patients was 2.1 : 1 and distribution of the age ranged from 11 to 66 years with the average age of 42.7.
Thirty-two patients had taken non-shunt surgery(16 Kobayashi, 9 Sugiura, 4 Hassab, 1 Walker, 1 TEPG and 1 direct variceal ligation) whereas eighteen patients had undergone shunt operation(7 Warren shunt, 6 conventional splenoreal shunt, 4
mesocaval
shunt and 1 portocaval shunt).
The operative mortality within 1 month after surgery was 18.8%(6 cases) in group of nonshunt operation and 5.6%(1 cases) in group of shunt operation. The causes of death were hepatorenal failure in 4 cases, hepatic coma 1 cases and acute renal
failure 1
case in group of non-shunt operation. Early post-operative complications(within 1 month after operation) were pulmonary complications(26.9%), ascites(11.5%), subphrenic abscess(11.5%) and rebleeding(7.7%) in group of non-shunt operation and there
were
pulmonury complications(23.5%), ascites(23.5%), rebleeding(5.9%) and hepatic encephalopathy(5.9%), in group of shunt surgery, Late complications(within 1 vear) were rebleeding(5.9%), hepatic encephalopathy(5.9%) in group of shunt operation and
esophageal stricutre(15.4%) in group of non-shunt surgery.
In follow-up survery, survival rate was higher in group of non-shunt operation(92%) more than group of shunt operation(86.7%).
Conclusively, in our study, Kobayashi operation showes good results as 7.7% rebleeding rate and 6.3% operative mortality rate compared with other procedures.
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