The authors report the results of 171 cases of portal systemic bypass operations out of a total of 200 cases operated on between 1968 and 1974. These 171 patients all presented with a syndrome of portal hypertension with oesophageal varices and all had previously bled. Their age lay in 70% of cases between 40 and 60 years and the cause of hypertension was in 96% of cases an intra-hepatic block. 41% were included in the risk group A according to Child's classification, 51% in Group B and 8% in Group C. The routine operation was side-to-side portacaval anastomosis (75%). The operative mortality was 5.2% in all with 1% in cases with risk A, and 15% in cases with risk C. The fall in portal pressure was on average 15 cm of water, i.e. 41% of the initial pressure. The overall survival after 5 years was 65%, 70% for risk A and 26% for risk C. In 69% of cases the cause of death was liver failure. Encephalopathy, studied in 76 patients over an average period of 3 years, occurred in 39% of cases, and in 13% of the latter it was serious. In the 12% of survivors, the authors noted recurrent hemorrhage, but in only 2.5% of cases did the bleeding definitely come from oesophageal varices. In the light of these results, the authors judge positively the surgical treatment of portal hypertension.
|Translated title of the contribution||Immediate and late results of 171 therapeutic portal systemic bypass operations|
|Number of pages||10|
|Journal||Journal de Chirurgie|
|Publication status||Published - 1977|
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