SURGICAL METHODS OF BLEEDING PREVENTION FROM ESOPHAGEAL VARICES IN TREATMENT FOR PATIENTS WITH LIVER CIRRHOSIS

• Main Authors: M. F. Zarivchatskiy, E. D. Kamenskikh, I. N. Mugatarov, M. V. Kolyvanova
• Format: Article
• Language: Russian
• Published: Pavlov First Saint Petersburg State Medical University 2017-04-01
• Series: Вестник хирургии имени И.И. Грекова
• Subjects: liver cirrhosis; portal hypertension; esophageal varices; relapse of bleeding
• Online Access: https://www.vestnik-grekova.ru/jour/article/view/313

E.A. Vagner Perm State Medical University OBJECTIVE. The authors would like to improve the results of surgical treatment of patients with threat of bleeding from esophageal varices. MATERIALS AND METHODS. The study included 90 patients with esophageal varices on the background of liver cirrhosis. Portocaval bypass was performed on 21 patients. The direct interventions on the stomach and esophageal varices were carried out in 29 patients. The endoscopic ligation of esophageal varices was used in 40 cases. RESULTS. The rate of cumulative survival after portocaval bypass was 93,3±6,4 % (up to1 year), 3-year survival rate counted 66,7±12,2 % and 5-year rate was 60,0±12,7 % , respectively. The rate of survival after direct interventions on the stomach and esophageal varices consisted of 92,9 %±6,9 %, 76,0±12,2 % and 65,1±14,5 %, respectively. The survival rate after the endoscopic ligation of esophageal varices class A and B in Child-Pugh numbered 100 %, 91,0±8,7 % and 54, 6±20,6 %, but in case of the class C survival rate counted 60,0±20,4 %, 45,0 %±18,8 and 22,5±18,5 %, respectively. CONCLUSIONS. The authors recommend to apply the long-term courses of endo scopic ligation of esophageal varices in order to prevent bleeding from them. The methods of portcaval bypass or direct intervention should be used in case of lack of effect of endoscopic ligation method.