RESULTS OF PORTOSYSTEMIC SHUNTING IN THE ERLY POSTOPERATIVE PERIOD
DOI:
https://doi.org/10.54890/.v4i4.1057Abstract
In the conditions of Kyrgyzstan, operations to create portosystemic anastomoses are not only a measure for the prevention of bleeding from the Varicose veins of the esophagus and stomach, before liver transplantation, but also the final method of treatment for this category of patients, because for many patients there is simply no possibility for radical surgical treatment of cirrhosis.
The experience of surgical treatment of 153 patients with portal hypertension from 1997 to 2016 was analyzed.
Proximal splenorenal anastomosis (PSRA) with splenectomy was formed in 78 (50.9%) patients. Of 78 (50.9%) patients, 55 (35.9%) patients underwent standard splenectomy with the formation of an end-to-side PSRA. In 3 (21.4%) patients, interventions were performed at the height of bleeding from varicose veins of the esophagus, the remaining 11 (78.6%) patients were performed as planned. PSS thrombosis developed in 13 (8.5%) patients, the largest number of thrombosis occurred in PSRA, in 10 (6.5%) of 13 cases, which is possibly associated with the greatest trauma to the pancreas. 7 (4.6%) patients died from relapse of Gastroesophageal bleeding due to thrombosis of the portosystemic shunt.
Rules that must be followed to minimize complications: the use of the lower pole branch of the splenic vein to form portioned proximal splenorenal anastomosis, this allows: to preserve hepatopetal blood flow; control the patency and consistency of the anastomosis; prevent thrombosis of the anastomosis.We consider the splenorenal side-to-side anastomosis to be the most physiological and effective organ-preserving portosystemic shunt.
Keywords:
liver cirrhosis, portal hypertension, splenorenal anastomosis, portosystemic shunting, hepatology.References
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