Preview

Medical Herald of the South of Russia

Advanced search

ADAPTING PORTAL DECOMPRESSION FOR ELEVATION OF EFFICACY OF PORTOSYSTEMIC SHUNTING OPERATIONS IN PORTAL HYPERTENSION

https://doi.org/10.21886/2219-8075-2016-3-100-103

Abstract

Purpose: to improve the results of portosystemic shunting surgical interventions using of procedures of adapting portal decompression during preoperation period.

Materials and Methods: the results of transjugular intrahepatic portosystemic shunt (TIPS procedure) in 113 patients were analyzed. In 60 cases the procedure of adapting portal decompression during a period 3-5 weeks using selective vasoconstrictor octreotide in complex with non-selective beta-blockers.

Results: during the follow-up postoperative period in group of patients who were undergone for adapting portal decompression the restitution of clinical and laboratory data was noticed and does not increase occurrence of hepatic insufficiency in comparison with control group.

Summary: using of adapting portal decompression in preoperative period before TIPS procedure in patients with complicated portal hypertension is effective for prophylaxis of making worse of hepatic insufficiency.

About the Authors

Yu. V. Khoronko
Rostov State Medical University
Russian Federation
Department of operative surgery and topographic anatomy


S. I. Dudarev
Rostov State Medical University
Russian Federation
Department of operative surgery and topographic anatomy


K. A. Glebov
Rostov State Medical University
Russian Federation
Department of operative surgery and topographic anatomy


References

1. Ивашкин В.Т., Маевская М.В. Лечение осложнений цирроза печени: методические рекомендации для врачей / В.Т.Ивашкин, М.В.Маевская. – М.: Литтерра. – 2011. – 64 с. (Серия “Практические руководства”).

2. Orloff M.J. Fifty-three years’ experience with randomized clinical trials of emergency portacaval shunt for bleeding esophageal varices in Cirrhosis: 1958-2011 // JAMA Surg. – 2014. – Vol.149, N.2. – P.155-169.

3. Борисов А.Е. Цирроз печени и портальная гипертензия / А.Е.Борисов, В.А.Кащенко. – СПб., 2009. – 112 с.

4. Шерцингер А.Г., Жигалова С.Б., Лебезев В.М., Манукьян Г.В., Киценко Е.А. Современное состояние проблемы хирургического лечения больных портальной гипертензией // Хирургия имениН.И.Пирогова. – 2013. №2. – С.30-34.

5. Garcia-Tsao G., Bosch J., Groszmann R.J. Portal hypertension and variceal bleedingUnresolved issues. Summary of an Аmerican association for the study of liver diseases and Еuropean association for the study of liver single-topic conference // Hepatology. – 2008. – Vol. 47. – P.1764–1772.

6. Gines P., Fernandez J., Durand F., Saliba F. Management of criticallyill cirrhotic patients // J Hepatol. – 2012. – Vol.56, Suppl.1. – P.13-24.

7. Хоронько Ю.В., Дмитриев А.В., Шитиков И.В., Ерошенко О.Л., Микрюков В.А. Воротная вена как объект трансъюгулярного внутрипеченочного портосистемного шунтирования (TIPS/ ТИПС) при портальной гипертензии, вызванной циррозом // Фундаментальные исследования. – 2013. №11 (часть 1). – С.95-99.

8. Ripoll C., Groszmann R., Garcia-Tsao G. Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis // Gastroenterology. – 2007. – Vol. 133. – P.481–488.

9. Silkauskaite V., Pranculis A., Motraite D. Hepapatic venous pressure gradient measurement in patients with liver cirrhosis: a correlation with disease severity and variceal bleeding // Medicina (Kaunas). – 2009. – Vol.45, N.1. – P.8-13.

10. Loffroy R., Estivalet L., Cherblanc V. Transjugular intrahepatic portosystemic shunt for the management of acute variceal hemorrhage // World J Gastroenterol. – 2013. – Vol.19, N.37. – P.6131-6143.

11. Siramolpivat S. Transjugular intrahepatic portosystemic shunts and portal hypertension-related complications / S. Siramolpivat // World J Gastroenterol. – 2014. – Vol.20, N.45. – P.6996-7010.

12. Villanueva C., Aracil C., Colomo A. Acute hemodynamic response to beta-blockers and prediction of long-term outcome in primary prophylaxis of variceal bleeding // Gastroenterology. – 2009. – Vol. 137. – P.119–128.

13. Giannelli V., Lattanzi B., Thalheimer U., Merli M. Beta-blockers in liver cirrhosis / // Ann Gastroenterol. – 2014. – Vol.27. – P.20-26.

14. Wells M., Change N.,Adams P., Beaton M., Levstik M., Boyce E. Meta-analysis: vasoactive medications for the management of acute variceal bleeds // Aliment Pharmacol Ther. – 2012. – Vol.35, N.11. – P.1267-1278.

15. Vuachet D., Cervoni J.P., Vuitton L., Weil D., Dritsas S., Dussaucy A., Koch S., Di Martino V. Improved survival of cirrhotic patients with variceal bleeding over the decade 2000-2010 // Clin Res Hepatol Gastroenterol. – 2015. – Vol.39, N.1. – P.59-67.


Review

For citations:


Khoronko Yu.V., Dudarev S.I., Glebov K.A. ADAPTING PORTAL DECOMPRESSION FOR ELEVATION OF EFFICACY OF PORTOSYSTEMIC SHUNTING OPERATIONS IN PORTAL HYPERTENSION. Medical Herald of the South of Russia. 2016;(3):100-103. (In Russ.) https://doi.org/10.21886/2219-8075-2016-3-100-103

Views: 751


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2219-8075 (Print)
ISSN 2618-7876 (Online)