Right lateral decubitus approach to a laparoscopic modified <scp>H</scp>assab's operation

Tanaka, Motomu; Ikeda, Yoshifumi; Matsui, Shimpei; Kato, Ayu; Nitori, Nobuhiro; Kadomura, Tomohisa; Hatori, Takashi; Kitajima, Masaki

doi:10.1111/ases.12252

Cited by 5 publications

(6 citation statements)

References 7 publications

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“…High rebleeding risk was an issue when the procedure was first introduced, but the postoperative results have improved with technological advances. Furthermore, thanks to recent advances in vessel sealing systems, laparoscopic Hassab's procedure has been increasingly performed in Eastern countries 4,5,9–13 . In 2012, we reported our preliminary results of laparoscopic surgery for patients with portal hypertension 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, thanks to recent advances in vessel sealing systems, laparoscopic Hassab's procedure has been increasingly performed in Eastern countries. 4,5,[9][10][11][12][13] In 2012, we reported our preliminary results of laparoscopic surgery for patients with portal hypertension. 10 In one of the subgroup analyses in that report, laparoscopic (n = be lower in the laparoscopic group (531 g) than in the open group (778 g).…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] Laparoscopic Hassab's procedure is the most minimally invasive operation for patients with endoscopic-resistant esophagogastric varices. Although the short-term results after laparoscopic Hassab's procedure showed the safety and effectiveness of this operation, 4,5,[9][10][11][12][13] the long-term results remain unclear. This study therefore aimed to investigate the surgical feasibility, including long-term results, of laparoscopic Hassab's procedure.…”

Section: Introductionmentioning

confidence: 99%

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Long‐term results of laparoscopic Hassab's procedure for esophagogastric varices with portal hypertension

Fujisaki

Fukami

Arikawa

et al. 2022

Asian J Endoscop Surgery

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Introduction: Recent reports have shown laparoscopic gastric devascularization and splenectomy (Hassab's procedure) to be a safe and effective treatment for esophagogastric varices with portal hypertension. However, the long-term postoperative results remain unclear.Methods: Between 2009 and 2015, 17 patients with portal hypertension and esophagogastric varices underwent laparoscopic Hassab's procedure at our institution. Two patients were lost to long-term follow-up (at least 2 years) and excluded. The remaining 15 patients' data and endoscopic findings were retrospectively reviewed. Results:The median postoperative follow-up period was 56 months. The median spleen volume, operation time, blood loss, and length of postoperative hospital stay were 651 (320-1,265) mL, 305 (275-547) minutes, 347 (24-1,131) mL, and 20 (8-41) days, respectively. According to the endoscopic findings 1 year after surgery, the esophagogastric varices disappeared in three patients and improved in 12 patients. The median platelet count was significantly higher 1 year after surgery (19.7 Â 10 4 /dL) than before surgery (5.5 Â 10 4 /dL) (P < .001) and remained stable 2 years after surgery. Two patients died of liver disease. The remaining 13 patients, with a median postoperative follow-up of 57 months, were alive without bleeding from esophagogastric varices.Conclusion: Laparoscopic Hassab's procedure is a feasible treatment for esophagogastric varices with portal hypertension in terms of both short-and long-term results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long‐term results of laparoscopic Hassab's procedure for esophagogastric varices with portal hypertension

Fujisaki

Fukami

Arikawa

et al. 2022

Asian J Endoscop Surgery

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“…Одним из современных направлений минимально инвазивной хирургии ПГ является разработка и внедрение эндовидеохирургических вмешательств. Показаниями к лапароскопической деваскуляризации желудка и пищевода считают рецидивирующие ПЖК при безуспешности эндоскопических вмешательств и невозможности выполнения TIPS или формирования хирургического шунта, а симультанную лапароскопическую спленэктомию выполняют при тяже лом гиперспленизме, резистентном к эндоваскулярной коррекции [23,24]. В метаанализе сравнительных исследований лапароскопической и открытой деваскуляризации желудка и пищевода со спленэктомией было показано, что мини-инвазивные эндовидеохирургические вмешательства характеризуются меньшей интраоперационной кровопотерей (р = 0,003) и более коротким периодом госпитализации (р < 0,001), а частота послеоперационных осложнений была одинаковой в обеих группах.…”

Section: Discussionunclassified

“…ПЖК в раннем после операционном периоде не было. Таким обра зом, лапароскопическая деваскуляризация желудка и абдоминального отдела пищевода с сохранением или удалением селезенки является альтернативным безопасным и эффективным минимально инвазивным методом лечения и профилактики ПЖК портального генеза у больных ЦП [11,23,24]. Согласно собственным данным, рецидив ПЖК в раннем периоде после лапароскопической деваскуляризации желудка и пищевода развился в 10,7% наблюдений, а в отдаленном -в 42,3%.…”

Section: Discussionunclassified

Minimally invasive ways to treat and prevent gastroesophageal portal bleeding

et al. 2022

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Aim. To analyze the results of minimally invasive techniques to prevent and treat gastroesophageal bleeding in patients with cirrhosis.Materials and methods. The study included 997 patients with liver cirrhosis: Child-Pugh class A – 21.7%; class B – 48.8%; class C – 29.5%. Esophageal varices of Grades III–IV were diagnosed in 95.5% of the patients, while gastric varices were observed in 17.4% of the patients. The following methods were used: endoscopic ligation, endoscopic sclerotherapy, TIPS, laparoscopic azygoportal disconnection, and distal splenorenal anastomosis.Results. Following endoscopic procedures aimed at preventing the onset of gastroesophageal bleeding, variceal recurrence and bleeding were observed in 35.9% and 18.6% of cases, respectively. The efficacy of endoscopic ligation in case of bleeding amounted to 91.2%. Multiple endoscopic procedures provided means to treat esophageal and gastric varices in 56.2% of the patients. Rebleeding was observed in 9.3% of the patients, while esophageal and gastric varices persisted in 34.3% of the patients. TIPS was found to significantly reduce portal pressure and the grade of varices, with encephalopathy developing in 41.4% of the patients. In the long-term period, stent dysfunction was diagnosed in 22.5% of cases, while bleeding recurred in 10%. Laparoscopic azygoportal disconnection contributed to the regression of esophageal and gastric varices. In the long-term period, bleeding recurred in 42.3% of cases. Laparoscopic distal splenorenal anastomosis reliably prevented the recurrence of bleeding. No shunt thrombosis or lethal outcomes were observed, while the incidence of encephalopathy amounted to 14.7%.Conclusion. A sufficient number of minimally invasive methods are currently available in the treatment and prevention of gastroesophageal portal bleeding. A case-specific approach to the choice of measures aimed at treating and preventing gastroesophageal bleeding in patients with cirrhosis is required, taking into account the degree of decompensation of portal hypertension and the severity of liver dysfunction.

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Modern strategies for the treatment and prevention of bleeding from gastric

Kotiv,

Dzidzava,

Dzhafarov

et al. 2024

Ann. hir. gepatol.

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Aim. To analyze the results of modern prevention and treatment strategies applied for bleeding from gastric varices in patients with portal hypertension syndrome.Materials and methods. The study enrolled 276 patients with portal hypertension, including 187 cases of liver cirrhosis and 89 cases of extrahepatic portal hypertension. 24% of the patients with liver cirrhosis were classified as Child-Turcotte-Pugh Class A, 50% as Class B, and 26% as Class C. The portal vein thrombosis was confirmed in 80% of extrahepatic portal hypertension cases, while isolated splenic vein thrombosis was observed in 20%. Varices GOV1 (Sarin classification) were identified in 126 patients (45.7%), GOV2 in 110 patients (39.8%), and IGV-1 in 40 patients (14.5%). The following interventions were performed: endoscopic ligation, endoscopic sclerotherapy, endovascular techniques (transjugular intrahepatic portosystemic shunt, balloon-occluded retrograde transvenous obliteration), laparoscopic gastric devascularization, and distal splenorenal anastomosis.Results. Following endoscopic procedures, recurrence of gastric varices was noted in 20% of cases, and bleeding occurred in 7%. The efficacy of endoscopic treatment amounted to 71%; endoscopic ligation for bleeding from GOV1 varices appeared effective in 94.4% of cases. Early recurrence of bleeding developed in 29.4% of patients. The efficacy of endoscopic sclerotherapy for bleeding from GOV2/IGV1 varices comprised 96.7% with early recurrence occurring in 12.9% of patients. The secondary prevention involved multiple endoscopic interventions that led to complete eradication of gastric varices in 34% of cases with recurrent bleeding noted in 9.3% of patients, while persistent recurrence of gastric varices was observed in 66%. A splenorenal anastomosis provided reliable prevention of recurrent bleedings. No shunt thrombosis or mortality was recorded; however, the incidence of post-shunt encephalopathy comprised 16.5%. Transjugular intrahepatic portosystemic shunt facilitated a significant reduction in portal pressure and the enlargement of esophageal and gastric varices. Post-shunt encephalopathy occurred in 48.6% of patients. In the long-term follow-up, a recurrence of esophagogastric bleeding was recorded in one patient. Laparoscopic azygoportal disconnection contributed to the regression of varices in the esophagus and stomach; however, a recurrence of gastric varices developed in 30% of cases and a recurrence of bleeding in 12.5%.Conclusion. Current medicine obtains a sufficient arsenal of modern methods for the treatment and prevention of bleeding from gastric varices. The choice of treatment and prevention strategies for bleeding in portal hypertension necessitates a differentiated approach, taking into account the etiology and degree of disease decompensation.

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Right lateral decubitus approach to a laparoscopic modified Hassab's operation

Cited by 5 publications

References 7 publications

Long‐term results of laparoscopic Hassab's procedure for esophagogastric varices with portal hypertension

Long‐term results of laparoscopic Hassab's procedure for esophagogastric varices with portal hypertension

Minimally invasive ways to treat and prevent gastroesophageal portal bleeding

Modern strategies for the treatment and prevention of bleeding from gastric

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