- 作者：Hironori Hayashi ; ekhayashi@hotmail.com ; Hiroyuki Takamura ; Yukari Yamaguchi ; Yasuhiro Shoji ; Hisatoshi Nakagawara ; Hidehiro Tajima ; Ichiro Onishi ; Hirohisa Kitagawa ; Takashi Tani ; Masato Kayahara ; Tetsuo Ohta
- 关键词：gastroesophageal varices ; liver cirrhosis ; splenectomy
- 刊名：Asian Journal of Surgery
- 出版年：2012
- 期刊代码：24_10159584
- 类别：med
- 出版时间：April, 2012
- 卷：35
- 期：2
- 页码：57-61
- 文件大小：262 K
Summary
Background/Objective
Recently, endoscopic and radiological procedures for various symptoms related to cirrhosis have improved. Thus, the role of Hassab's operation (gastroesophageal decongestion and splenectomy) has changed for cirrhotic patients.Methods
Hassab's operation was performed on patients who had gastroesophageal varices that were difficult to control with balloon occluded retrograde transvenous obliteration or an endoscopic procedure, or had hypersplenism. Thirteen consecutive patients underwent this operation, and the outcomes of all patients were reviewed retrospectively.
Results
There was no operative morbidity or rebleeding varices. In the preoperative endoscopic injection sclerotherapy treated group (n = 6), only one patient (16.7%) developed recurrent varices. Mean platelet counts were significantly higher 6 months after surgery (201 卤 65 脳 103/mm3) than preoperatively (64 卤 54 脳 103/mm3). In patients with hepatocellular carcinoma, percutaneous therapies, such as radio frequency ablation, were safely performed with adequate therapeutic effect. Interferon therapy was given to patients with hepatitis C virus (HCV)-related cirrhosis without interruption.
Conclusion
Hassab's operation is a satisfactory approach to controlling varices, especially when combined with preoperative endoscopic treatment. Platelet counts were significantly higher after surgery. This therapy was important for cirrhotic patients contraindicated for liver transplantation in that they could continue their therapy for hepatocellular carcinoma (HCC) and HCV as needed.