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Recent role of Hassab's operation for cirrhotic patients: combination with endoscopic procedure for varices

Hironori Hayashi1, Hiroyuki Takamura, Yukari Yamaguchi

  • 1Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Japan. ekhayashi@hotmail.com

Asian Journal of Surgery
|June 23, 2012
PubMed

Insights

Hassab's operation effectively controls gastroesophageal varices in cirrhotic patients, improving platelet counts and allowing continued treatment for hepatocellular carcinoma and hepatitis C virus. This surgical approach offers a viable option when liver transplantation is contraindicated.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Surgical Oncology

Background:

  • Endoscopic and radiological interventions for cirrhosis symptoms have advanced.
  • The role of Hassab's operation (gastroesophageal decongestion and splenectomy) has evolved for cirrhotic patients.

Purpose of the Study:

  • To evaluate the efficacy and safety of Hassab's operation in managing gastroesophageal varices and hypersplenism in cirrhotic patients.
  • To assess the impact of Hassab's operation on platelet counts and its role in facilitating further treatment for hepatocellular carcinoma (HCC) and hepatitis C virus (HCV).

Main Methods:

  • Retrospective review of 13 consecutive patients who underwent Hassab's operation.
  • Patients had gastroesophageal varices refractory to other treatments or hypersplenism.
  • Outcomes included operative morbidity, rebleeding, platelet counts, and ability to undergo subsequent therapies.

Main Results:

  • No operative morbidity or rebleeding was observed.
  • Mean platelet counts significantly increased 6 months post-surgery (201 ± 65 × 10(3)/mm(3) vs. 64 ± 54 × 10(3)/mm(3) preoperatively).
  • Percutaneous therapies for HCC and interferon for HCV were safely administered post-operation.

Conclusions:

  • Hassab's operation is a satisfactory method for controlling varices, particularly when combined with preoperative endoscopic treatment.
  • The procedure leads to significant improvement in platelet counts.
  • It is a crucial option for cirrhotic patients ineligible for liver transplantation, enabling necessary HCC and HCV treatments.
Abstract

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