Long-term prognosis of non-shunt operation for idiopathic portal hypertension

J Gastroenterol. 1998 Apr;33(2):241-6. doi: 10.1007/s005350050077.

Abstract

This report presents 46 Japanese patients with idiopathic portal hypertension (IPH) in whom non-shunt operation was performed for the management of esophageal varices. Non-shunt operation included transthoracic esophageal transection (Sugiura's procedure) in 37 patients, transabdominal esophageal transection (TAET) in 3 patients, and Hassab's procedure in 6 patients. Rates of postoperative variceal eradication were: 78.4% by Sugiura's procedure; 100% by TAET; and 50% by Hassab's procedure. The cumulative rates for recurrent varices and recurrent bleeding were 3.9%, and 5.1%, respectively, at 5 years, and 8.9% and 9.8% at both 10 and 15 years. Only 3 patients required additional endoscopic injection sclerotherapy to treat recurrent varices. Although 3 patients developed upper gastrointestinal bleeding, the source of hemorrhage was esophageal varices in 1, and portal hypertensive gastropathy in 2; none of the patients died from bleeding. Actuarial survival for all patients was 87.5% at 5 years, 77.9% at 10 years, and 58.8% at 15 years. There were no deaths within the first 30 days after surgery. These results show that non-shunt operation is useful in preventing bleeding from esophageal varices in patients with IPH.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Esophageal and Gastric Varices / surgery
  • Esophagus / surgery
  • Female
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Hypertension, Portal / mortality
  • Hypertension, Portal / surgery*
  • Male
  • Methods
  • Middle Aged
  • Prognosis
  • Recurrence
  • Sclerotherapy
  • Survival Rate
  • Time Factors
  • Treatment Outcome