Skip to main content
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1987 Oct 31;295(6606):1115–1117. doi: 10.1136/bmj.295.6606.1115

Operations for portal hypertension due to extrahepatic obstruction: results and 10 year follow up.

G K Pande 1, V M Reddy 1, P Kar 1, P Sahni 1, M Berry 1, B N Tandon 1, S Nundy 1
PMCID: PMC1248187  PMID: 3120906

Abstract

Between 1976 and 1984, 136 patients with portal hypertension due to extrahepatic obstruction were operated on. Twenty two patients had emergency and 114 elective operations. The operative mortality was 9% and 1%, respectively. Altogether 117 patients (86%) were followed up for from two to 10 years: 17 rebled, none developed encephalopathy or sepsis after splenectomy, and 90% and 75% were alive at five and 10 years respectively. Unlike endoscopic sclerotherapy and treatment with propranolol, operative treatment of variceal bleeding can usually be completed during one admission and carries a low mortality and a fairly low morbidity. Operation seems to be the best form of treatment for poor patients living far from medical facilities in developing countries and may be the treatment of choice in developed countries as well.

Full text

PDF
1115

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Belli L., Romani F., Sansalone C. V., Aseni P., Rondinara G. Portal thrombosis in cirrhotics. A retrospective analysis. Ann Surg. 1986 Mar;203(3):286–291. doi: 10.1097/00000658-198603000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bismuth H., Franco D., Alagille D. Portal diversion for portal hypertension in children. The first ninety patients. Ann Surg. 1980 Jul;192(1):18–24. doi: 10.1097/00000658-198007000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. CLATWORTHY H. W., Jr, BOLES E. T., Jr Extrahepatic portal bed block in children: pathogenesis and treatment. Ann Surg. 1959 Sep;150:371–383. doi: 10.1097/00000658-195909000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cohen D., Mansour A. Extrahepatic portal hypertension--long-term results. Prog Pediatr Surg. 1977;10:129–140. [PubMed] [Google Scholar]
  5. Conn H. O. Ammonia tolerance in the diagnosis of esophageal varices. A comparison of endoscopic, radiologic, and biochemical techniques. J Lab Clin Med. 1967 Sep;70(3):442–451. [PubMed] [Google Scholar]
  6. Drapanas T. Interposition mesocaval shunt for treatment of portal hypertension. Ann Surg. 1972 Oct;176(4):435–448. doi: 10.1097/00000658-197210000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fonkalsrud E. W., Myers N. A., Robinson M. J. Management of extrahepatic portal hypertension in children. Ann Surg. 1974 Oct;180(4):487–493. doi: 10.1097/00000658-197410000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fonkalsrud E. W. Surgical management of portal hypertension in childhood: long-term results. Arch Surg. 1980 Sep;115(9):1042–1045. doi: 10.1001/archsurg.1980.01380090022006. [DOI] [PubMed] [Google Scholar]
  9. Grauer S. E., Schwartz S. I. Extrahepatic portal hypertension: a retrospective analysis. Ann Surg. 1979 May;189(5):566–574. doi: 10.1097/00000658-197905000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hassab M. A. Nonshunt operations in portal hypertension without cirrhosis. Surg Gynecol Obstet. 1970 Oct;131(4):648–654. [PubMed] [Google Scholar]
  11. Maddrey W. C., Sen Gupta K. P., Mallik K. C., Iber F. L., Basu A. K. Extrahepatic obstruction of the portal venous system. Surg Gynecol Obstet. 1968 Nov;127(5):989–998. [PubMed] [Google Scholar]
  12. Sarin S. K., Nundy S. Subclinical encephalopathy after portosystemic shunts in patients with non-cirrhotic portal fibrosis. Liver. 1985 Jun;5(3):142–146. doi: 10.1111/j.1600-0676.1985.tb00229.x. [DOI] [PubMed] [Google Scholar]
  13. VOORHEES A. B., Jr, HARRIS R. C., BRITTON R. C., PRICE J. B., SANTULLI T. V. PORTAL HYPERTENSION IN CHILDREN: 98 CASES. Surgery. 1965 Sep;58:540–549. [PubMed] [Google Scholar]
  14. Voorhees A. B., Jr, Chaitman E., Schneider S., Nicholson J. F., Kornfeld S., Price J. B., Jr Portal-systemic encephalopathy in the noncirrhotic patient. Effect of portal-systemic shunting. Arch Surg. 1973 Nov;107(5):659–663. doi: 10.1001/archsurg.1973.01350230017005. [DOI] [PubMed] [Google Scholar]
  15. Voorhees A. B., Jr, Price J. B., Jr Extrahepatic portal hypertension. A retrospective analysis of 127 cases and associated clinical implications. Arch Surg. 1974 Mar;108(3):338–341. doi: 10.1001/archsurg.1974.01350270068012. [DOI] [PubMed] [Google Scholar]
  16. WALKER R. M. Treatment of portal hypertension in children. Proc R Soc Med. 1962 Sep;55:770–772. [PubMed] [Google Scholar]
  17. Webb L. J., Sherlock S. The aetiology, presentation and natural history of extra-hepatic portal venous obstruction. Q J Med. 1979 Oct;48(192):627–639. [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES