Prophylactic surgery in non-cirrhotic portal fibrosis:is it worthwhile?
dc.contributor.author | Pal, Sujoy | en_US |
dc.contributor.author | Radhakrishna, P | en_US |
dc.contributor.author | Sahni, Peush | en_US |
dc.contributor.author | Pande, Girish K | en_US |
dc.contributor.author | Nundy, Samiran | en_US |
dc.contributor.author | Chattopadhyay, Tushar K | en_US |
dc.date.accessioned | 2005-11-21 | en_US |
dc.date.accessioned | 2009-05-29T03:14:20Z | |
dc.date.available | 2005-11-21 | en_US |
dc.date.available | 2009-05-29T03:14:20Z | |
dc.date.issued | 2005-11-21 | en_US |
dc.description.abstract | BACKGROUND: In cirrhotic patients with portal hypertension prophylactic portasystemic shunts have been found to be ineffective as deaths from post-shunt liver failure exceed those from bleeding. However, in patients with non-cirrhotic portal hypertension, variceal bleeding rather than liver failure is the common cause of death. In developing countries shortage of tertiary health-care facilities and blood banks further increases mortality due to variceal bleed. AIM: To study the results of prophylactic operations to prevent variceal bleeding in patients with portal hypertension due to non-cirrhotic portal fibrosis (NCPF). METHODS: Between 1976 and 2001, we performed 45 prophylactic operations in patients with NCPF, if the patients had high-risk esophagogastric varices or symptomatic splenomegaly and hypersplenism. Proximal lienorenal shunt was done in 41 patients and the remaining underwent splenectomy with (2 patients) or without (2 patients) devascularization. RESULTS: There was no operative mortality. Thirty-eight patients were followed up for a mean 49 (range, 12-236) months. Three patients bled - one was variceal and two due to duodenal ulcers; none died of bleeding. There were 2 late deaths (6 weeks and 10 years after surgery), one from an unknown cause and one due to chronic renal failure. The delayed morbidity was 47%. This included 7 patients who developed portasystemic encephalopathy, 4 glomerulonephritis, 2 pulmonary arteriovenous fistulae and 5 ascites requiring treatment with diuretics. Thus only 20 (53%) patients were symptom-free on follow up. CONCLUSIONS: Prophylactic surgery is safe and effective in preventing variceal bleeding in NCPF but at the cost of high delayed morbidity. | en_US |
dc.description.affiliation | Department of GI Surgery and Liver Transplantation, All India Institute of Medical Sciences, New Delhi, India. sujoypal@hotmail.com | en_US |
dc.identifier.citation | Pal S, Radhakrishna P, Sahni P, Pande GK, Nundy S, Chattopadhyay TK. Prophylactic surgery in non-cirrhotic portal fibrosis:is it worthwhile? Indian Journal of Gastroenterology. 2005 Nov-Dec; 24(6): 239-42 | en_US |
dc.identifier.uri | https://imsear.searo.who.int/handle/123456789/65101 | |
dc.language.iso | eng | en_US |
dc.source.uri | https://www.indianjgastro.com | en_US |
dc.subject.mesh | Adolescent | en_US |
dc.subject.mesh | Adult | en_US |
dc.subject.mesh | Child | en_US |
dc.subject.mesh | Esophageal and Gastric Varices --prevention & control | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Fibrosis | en_US |
dc.subject.mesh | Gastrointestinal Hemorrhage --prevention & control | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Hypertension, Portal --surgery | en_US |
dc.subject.mesh | Male | en_US |
dc.subject.mesh | Middle Aged | en_US |
dc.subject.mesh | Portal Vein --pathology | en_US |
dc.subject.mesh | Portasystemic Shunt, Surgical | en_US |
dc.subject.mesh | Postoperative Complications | en_US |
dc.title | Prophylactic surgery in non-cirrhotic portal fibrosis:is it worthwhile? | en_US |
dc.type | Journal Article | en_US |
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