Title: Devascularization for Portal Hypertension not Obsolete: Technical Details and Experience of 104 Cases
Authors: Sadaf Ali, Omar J Shah, K Sudarshan Reddy, Faroze Khan, Ajaz A Wani
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.101
Abstract
Background- Portal hypertension of various etiologies results in various complications, of which most common and dreaded complication is esophago-gastric varices and its bleed. Devascuarisation with our modified technique has a vital role in the management of esophago-gastric vertices, it’s not obsolete procedure.
Methods- A Prospective study of 104 patients underwent our modified Devascularization procedure over a period of 8 years from January 2006 to December 2014 in surgical gastroenterology department, SKIMS, INDIA. These patients had a follow up of 8 years to minimum of 1 year. The study patients were compiled in 2015.
Results- In our study with our Devascularisation technique, the operative time was 150 mins+/- 30 min, operative blood loss was300 ml +/- 50 ml, during post operative follow up there was no esophageal leak or stenosis, noresidualvarices (0%) and noencephalopathy observed. In12 patients developed recurrentvarices (12.53%), rebleeding occurred in 8(7.69%) patients and 9 patients were died (8.65%), all of them were Child C.
Conclusion- In failed medical and endoscopic management of esophagogastric varicesour devascularisation technique has an important role, with less post operative morbidity and mortality and its role will only continue to evolve .
Keywords- Esophago-gasricvarices, our devascularistion technique, portosystemic shunts, recurrent varices, rebleed, encephalopathy, mortality.
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