Early Experience with Surgical Management of Non-Cirrhotic Portal Hypertension in Nigeria: Report from a Single Centre

Abstract

Introduction: Portal hypertension is characterised by an increase in portal pressure. It may be a result of cirrhosis of the liver or non-cirrhotic hepatic and portal vein diseases. Non-cirrhotic portal hypertension (NCPH) is caused by a heterogeneous group of diseases affecting the liver and extrahepatic locations. In our setting, the most common cause of NCPH is schistosomiasis. We describe our experience in the surgical management of NCPH. Materials and Methods: This is a single centre retrospective study of all patients who had surgery for NCPH from January 2015 to December 2023 was retrieved for data collection. Data collected included the cause of portal hypertension, age, gender, indication for surgery, type of surgery, and outcome of surgery. Data were analysed using SPSS version 26. Results: A total of 13 patients had surgery for NCPH. The most common cause of NCPH was hepatosplenic schistosomiasis in 10 patients, whereas the remaining 3 patients had idiopathic NCPH. The indication for surgery was upper gastrointestinal bleeding secondary to oesophageal varices refractory to endoscopic therapy. The surgical intervention of choice includes the modified Sugiura procedure in five patients and the Hassab procedure in eight patients. Variceal rebleeding was seen in two patients within 1 year of surgery (15%) and in only three patients within 3 years of surgery (23%). Conclusion: Surgical treatment of NCPH is associated with good outcomes in patients with failed endoscopic therapy.