[Selective splenorenal shunt and post-transfusional hepatitis. Short and medium-term follow-up]

Area of Science:

• Hepatology
• Gastroenterology
• Surgical Research

Background:

• Portal hypertension presents a significant risk for patients, often necessitating surgical intervention.
• Esophageal varices rupture is a common complication, leading to digestive hemorrhage and requiring blood transfusions.
• Post-transfusion hepatitis remains a concern in managing patients with portal hypertension.

Purpose of the Study:

• To evaluate the incidence of post-transfusion hepatitis in patients with portal hypertension undergoing decompressive surgery.
• To assess the short and medium-term outcomes following selective splenorenal shunt in this patient cohort.
• To identify factors contributing to favorable surgical outcomes in portal hypertension management.

Main Methods:

• Study included 18 patients with portal hypertension (etiologies: schistosomiasis, cirrhosis, congenital hepatic fibrosis).
• Diagnosis confirmed by surgical biopsy during selective splenorenal shunt.
• Patients with a history of digestive hemorrhage from esophageal varices were included.

Main Results:

• The incidence of post-transfusion hepatitis was 44% (8 cases).
• Short and medium-term follow-up showed good outcomes irrespective of the cause of portal hypertension.
• Factors contributing to good outcomes included preserved hepatic function, younger patient age, and optimal surgical technique.

Conclusions:

• Selective splenorenal shunt can achieve favorable outcomes in selected portal hypertension patients.
• Vigilance for post-transfusion hepatitis is crucial, though it did not impede overall recovery in this cohort.
• Pre-operative hepatic function and surgical expertise are key determinants of successful portal hypertension management.