Results and Prospects of Portosystemic Shunting in Patients with Liver Cirrhosis
https://doi.org/10.16931/1995-5464.2015231-39
Abstract
Aim. To perform a comparative analysis of the results of portosystemic shunting with other competitive methods in patients with liver cirrhosis.
Materials and Methods. During the period from 1976 to 2015 in the department of portal hypertension and pancreatoduodenal zone surgery conventional portosystemic shunting (PSSh) was performed in 925 patients with portal hypertension (PH). Liver cirrhosis and extrahepatic obstruction caused portal hypertension in 867 (94.3%) and 58 (5.7%) patients respectively.
Results. Three study groups were analyzed: the first group – PSSh implementation phase for the period from 1976 to 1992; the second group – stage of partial shunts implementation (1992–1998); the third group – current stage with the introduction of portocaval drainage restrictions by the original method and the implementation of the TIPS technique (1998–2015). Main complication was fatal liver failure which accounted for over 70% of cases. For the last follow-up
on background of prophylactic hepatopetal flow-preserving bypass immediate postoperative mortality rate decreased to 2.7% in case of central bypass and to 3.9% in the selective decompression.
Conclusion. Traditional selective or partial central portosystemic shunting should be considered as an actual alternative in patients with functional classes A and B if the immediate prospect for liver transplantation is absent.
About the Authors
F. G. Nazyrov
Academician V. Vahidov Republican Specialized Surgery Center, Tashkent, Uzbekistan
Russian Federation
Doct. of Med. Sci., Professor, the Head of the Department of Portal Hypertension and Pancreatoduodenal Area Surgery, Director of the “Academician V. Vahidov Republican Specialized Surgery Center”
Russian Federation
Doct. of Med. Sci., Professor, the Head of the Department of Portal Hypertension and Pancreatoduodenal Area Surgery, Director of the “Academician V. Vahidov Republican Specialized Surgery Center”
A. V. Devyatov
Academician V. Vahidov Republican Specialized Surgery Center, Tashkent, Uzbekistan
Russian Federation
Russian Federation
Doct. of Med. Sci., Professor, Chief Scientific Officer of the Department of Portal Hypertension and Pancreatoduodenal Area Surgery of the “Academician V. Vahidov Republican Specialized Surgery Center”
A. Kh. Babadzhanov
Academician V. Vahidov Republican Specialized Surgery Center, Tashkent, Uzbekistan
Russian Federation
Russian Federation
Doct. of Med. Sci., Senior Researcher of the Department of Portal Hypertension and Pancreatoduodenal Area Surgery of the “Academician V. Vahidov Republican Specialized Surgery Center”
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Review
For citations:
Nazyrov F.G., Devyatov A.V., Babadzhanov A.Kh. Results and Prospects of Portosystemic Shunting in Patients with Liver Cirrhosis. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2015;20(2):31-39. (In Russ.) https://doi.org/10.16931/1995-5464.2015231-39
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