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KMID : 0870419980020020147
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
1998 Volume.2 No. 2 p.147 ~ p.156
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Surgical Management on Portal Hypertension With Esophageal Varices
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Lee Tae-Young
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Abstract
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Background/Aims: The aim of this study is to Compare the results of shunt operation with that of nonshunt operation.
Methods: Fifty six cases of portal hypertension with esophageal varices which, had undergone surgical operation at Pusan National University Hospital from January 1988 to December 1998 were reviewed retrospectively. Among forty-two
patients, 31 patients had undergone a direct approach (22 Kobayashi, 2 Sugiura, 2 Hassab, 4 TEPG, 1 direct variceal ligation), whereas 14 patients had undergone shunt operation (4 Warren shunt, 6 conventional splenorenal shunt, 2 mesocaval shunt, 2 portocaval shunt).
Results: Early postoperative complication included pulmonary complication(16.7%), rebleeding(4.8%) and ascites(4.8%) in the nonshunt operation group, while they included pulmonary complication(2.8%), hepatic failure(0.7%) and ascites(2.1%) in the shunt procedure group. Late complications were esophageal stricture(9.5%) in the nonshunt group and rebleeding(0.7%), hepatic encephalopathy(0.7%) in the shunt group. In a follow-up survey, the survival rate was higher in the nonshunt group(92%) slightly better than the shunt group(86.7%).
Conclusion: The Kobayashi operation shoves good results as 4.5% rebleeding rate and 9.1% operative mortality rate compared with other procedures.
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KEYWORD
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Portal hypertension, Esophageal varices, Shunt operation, Nonshunt operation
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