Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow‐Up

Ferreira, Fábio Gonçalves; Ribeiro, Mauricio Alves; Santos, Maria de Fátima; Assef, José Cesar; Szutan, Luiz Arnaldo

doi:10.1007/s00268-009-0196-y

Cited by 14 publications

(11 citation statements)

References 76 publications

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“…Evangelista Neto et al 9 , consider intra varicose pressure of 13 mmHg, achieved by ligation of the left gastric vein and splenectomy, secure for not indicate complementary sclerotherapy, since the varicose rupture occurs only from 20 mmHg. Opposite conduct of Sakay 24 and Ferreira et al 13 , who consider the indices of 13 mmHg of varicose pressure or 15,5 cm/sec of the portal flow at Doppler as satisfactory for installation of treatment of esophageal varices, due to the high chance of bleeding. Below these indices eliminate the need of the varicose treatment because schistosomal portal hypertension appears to depend on hyperflow 2 .…”

Section: Discussionmentioning

confidence: 98%

“…Statistical analysis was performed by paired Student t test with 95% CI for the degree and caliber of esophageal varices, the results were considered significant with p <0,05, using the computer program SPSS 13 . The presence or absence of red spots was analyzed by Fisher's exact test by Epidat 3.1, the results were considered significant with p <0,05.…”

Section: Discussionmentioning

confidence: 99%

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Perfil evolutivo das varizes esofágicas pós esplenectomia associada à ligadura da veia gástrica esquerda e escleroterapia na hipertensão portal esquistossomótica

Batista-Neto

Tognetti

Ribeiro

et al. 2013

ABCD, arq. bras. cir. dig.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Perfil evolutivo das varizes esofágicas pós esplenectomia associada à ligadura da veia gástrica esquerda e escleroterapia na hipertensão portal esquistossomótica

Batista-Neto

Tognetti

Ribeiro

et al. 2013

ABCD, arq. bras. cir. dig.

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“…Surgical treatment of schistosomal portal hypertension by splenectomy with ligation of left gastric vein, followed by postoperative endoscopic sclerosis is indicated in cases associated with prior upper gastrointestinal bleeding due to rupture of esophageal varices and/or gastric ulcers, or in cases of hypersplenism with important clinical consequences for the patient 1 In an attempt to identify risk factors that may compromise the postoperative outcome of patients undergoing surgery for disconnection and splenectomy, several authors have tried to preoperatively identify parameters that can improve late results in this group of patients, mainly with respect to rebleeding [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] .…”

Section: Introduction Introduction Introduction Introductionmentioning

confidence: 99%

Influência da inversão do diâmetro veia porta/veia esplênica nos resultados do tratamento cirúrgico da hipertensão portal esquistossomótica

Aa¹,

et al. 2011

Rev. Col. Bras. Cir.

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Results: 169 patients were analyzed, with follow-up averaging 23.6 months. Twenty-one patients (12.4%) had splenic vein caliber greater of equal than the portal vein's (Inversion -study group). The mean preoperative diameter of the portal and splenic veins were respectively 1.49 and 1.14 cm in the control group, and 0.98 versus 1.07 cm in the inversion group. The portal vein diameter was significantly higher in the control group when compared to the inversion group (p <0.05). Varices in the gastric fundus were found in 33.3% of the inversion group and in 38.5% of patients in the control group. Postoperative rebleeding occurred in 23.1% of patients in the inversion group and in 13.4% of the control group ones (p> 0.05). In the postoperative evaluation with Doppler ultrasonography of portal vessels, no cases of portal vein thrombosis were observed in the inversion group, whilst in the control group portal thrombosis was identified in 16.9% of the patients (p <0.05). Death occurred in one (4.8%) individual from the inversion group; mortality was 4.1% in the control group (p>0.05). The mean serum level of platelets was significantly lower (65,950/mm³) in the inversion group than in the controls (106,647/mm³) (p<0.05). Conclusion: Conclusion: Conclusion: Conclusion: Conclusion: The results suggest that the reversal of portal/splenic vein caliber ratio does not represent a contraindication to surgical treatment of schistosomal portal hypertension.

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“…However, non-derivative techniques are associated with a higher incidence of recurrent hemorrhaging and portal vein thrombosis (1,2,13,14,15,16,17,20,24,33,35) . The rate of recurrence of bleeding after treatment using non-derivative techniques varies.…”

Section: Trashepatic Left Gastric Vein Embolization In the Treatment mentioning

confidence: 99%

Trashepatic left gastric vein embolization in the treatment of recurrent hemorrhaging in patients with schistosomiasis previously submitted to non-derivative surgery

Saad

Razuk²,

Telles³

et al. 2012

Arq. Gastroenterol.

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-Context -Non-derivative surgical techniques are the treatment of choice for the control of upper digestive tract hemorrhages after schistosomotic portal hypertension. However, recurrent hemorrhaging due to gastroesophagic varices is frequent. Objective -To evaluate the outcome of treatment based on embolization of the left gastric vein to control the reoccurrence of hemorrhages caused by gastroesophagic varices in patients with schistosomiasis previously submitted to non-derivative surgery. Methods -Rates of reoccurrence of hemorrhages and the qualitative and quantitative reduction of gastroesophagic varices in patients undergoing transhepatic embolization of the left gastric vein between December 1999 and January 2009 were studied based on medical charts and follow-up reports. Results -Seven patients with a mean age of 39.3 years underwent percutaneous transhepatic embolization of the left gastric vein. The mean time between azigoportal disconnections employed in combination with splenectomy and the percutaneous approach was 8.4 ± 7.3 years, and the number of episodes of digestive hemorrhaging ranged from 1 to 7 years. No episodes of reoccurrence of hemorrhaging were found during a follow-up period which ranged from 6 months to 7 years. Endoscopic postembolization studies revealed reductions in gastroesophagic varices in all patients compared to preembolization endoscopy. Conclusions -Percutaneous transhepatic embolization of the left gastric vein in patients with schistosomiasis previously submitted to surgery resulted in a decrease in gastroesophagic varices and was shown to be effective in controlling hemorrhage reoccurrence.

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Doppler Ultrasound Could Predict Varices Progression and Rebleeding After Portal Hypertension Surgery: Lessons from 146 EGDS and 10 Years of Follow‐Up

Cited by 14 publications

References 76 publications

Perfil evolutivo das varizes esofágicas pós esplenectomia associada à ligadura da veia gástrica esquerda e escleroterapia na hipertensão portal esquistossomótica

Perfil evolutivo das varizes esofágicas pós esplenectomia associada à ligadura da veia gástrica esquerda e escleroterapia na hipertensão portal esquistossomótica

Influência da inversão do diâmetro veia porta/veia esplênica nos resultados do tratamento cirúrgico da hipertensão portal esquistossomótica

Trashepatic left gastric vein embolization in the treatment of recurrent hemorrhaging in patients with schistosomiasis previously submitted to non-derivative surgery

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