Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Research Article Volume 4 Issue 9

Analysis of Variceal Bleeding Recurrence Rate After Various Interventions in Extrahepatic Portal Hypertension

Ismailov SI1, Devyatov AV1, Babadjanov A Kh1*, Tuksanov AI1 and Boyko EV2

1Republican Specialized Scientific and Practical Medical Center of Surgery Named After Academic V. Vakhidov, Tashkent, Uzbekistan
2Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology of the Republic of Uzbekistan, Tashkent, Uzbekistan

*Corresponding Author: Babadjanov A Kh, Republican Specialized Scientific and Practical Medical Center of Surgery Named After Academic V. Vakhidov, Tashkent, Uzbekistan.

Received: July 30, 2021; Published: August 10, 2021

Abstract

Purpose: To conduct a comparative analysis of the incidence rate and period of gastric and esophageal varices bleeding recurrence associated with extrahepatic portal hypertension after different interventions.

Materials and Methods: The study included 131 patients with various forms of extrahepatic portal hypertension; who underwent operative therapy of extrahepatic portal hypertension in the Republican Specialized Scientific and Practical Medical Center of Surgery named after academic V. Vakhidov (RSSPMCS) for the period from 2006 to 2020. Most patients were adolescents (41.2%) and young age (45.0%). Total gastroesophageal basin disconnection was performed in 57 (43.5%) patients, portosystemic shunting - in 51 (38.9%) patients, and endoscopic interventions - in 23 (17.6%). 

Results: The comparative incidence rate of bleeding recurrence showed that the most effective intervention is portosystemic shunting. Significantly low efficiency is observed after endoscopic interventions, in which the incidence of hemorrhagic syndrome is 65.2% on average after 13.5 ± 2.9 months. While after a total disconnection of the gastroesophageal collector, a relapse-free course was noted in 35.1% (p = 0.014) of cases lasting 25.9 ± 4.4 months (p < 0.05), which in terms of timing did not differ significantly from relapses after portosystemic shunting - 41.4 ± 8.2 months, but significantly lower in the occurrence of variceal bleeding during decompression operations - 17.6% (p < 0.001). 

Conclusion: The most effective surgical intervention is portosystemic shunting with a bleeding recurrence freedom rate in 82.4% (p = 0.014) of patients. The most long-term recurrence period is within 41.4 months (p < 0.05), and with a 5-year persistent remission in 75.0% of patients. After disconnection operations, bleeding recurrence was noted in 35.1% of patients; the recurrence period averaged 19.6 months. 

Keywords: Extrahepatic Portal Hypertension; Operative Treatment; Gastric and Esophageal Varices Bleeding; Immediate and Long-Term Results

References

  1. Kumar A., et al. “Review article: portal vein obstruction--epidemiology, pathogenesis, natural history, prognosis and treatment”. Alimentary Pharmacology and Therapeutics3 (2015): 276-292.
  2. Pargewar SS., et al. “Imaging and radiological interventions in extra-hepatic portal vein obstruction”. World Journal of Radiology6 (2016): 556-570.
  3. Aman Elwadhi Sharmila B. “Mukherjee Extra Hepatic Portal Vein Obstruction – Unobstructed”. Indian Pediatrics3 (2018): 239-240.
  4. Khanna R and Sarin SK. “Idiopathic portal hypertension and extrahepatic portal venous obstruction”. Hepatology International1 (2018): 148-167.
  5. Sharma R., et al. “Clinico-epidemiological Profile of Extra Hepatic Portal Vein Obstruction: A Tertiary Care Hospital Based Retrospective Study”. Kathmandu University Medical Journal65 (2019): 30-34.
  6. Yogesh KC and Vijay B. “Portal vein thrombosis”. Journal of Clinical and Experimental Hepatology1 (2015): 22-40.
  7. Samant H., et al. “Portal Vein Thrombosis”. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing (2021).
  8. Sundeep Jain., et al. “Proximal spleno-renal shunt with retro-aortic left renal vein in a patient with extra-hepatic portal vein obstruction: first case report”. BMC Surgery1 (2017): 65.

Citation

Citation: Ismailov SI., et al. “Analysis of Variceal Bleeding Recurrence Rate After Various Interventions in Extrahepatic Portal Hypertension”. Acta Scientific Gastrointestinal Disorders 4.9 (2021): 03-08.

Copyright

Copyright: © 2021 Ismailov SI., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
Impact Factor0.835

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