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Related Experiment Videos

The Sugiura procedure: a prospective experience

D Mariette1, C Smadja, G Borgonovo

  • 1Groupe de Recherches sur la Chirurgie du Foie et de l'Hypertension Portale, Université Paris XI, Clamart, France.

Surgery
|March 1, 1994
PubMed
Summary

The Sugiura procedure effectively prevents recurrent esophageal varices bleeding with low operative risk and no significant hepatic encephalopathy. This surgical option is best for patients unresponsive to medical therapy.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Hepatology

Background:

  • Esophageal varices pose a significant bleeding risk in patients with liver disease.
  • The Sugiura procedure is designed to control variceal bleeding without impacting hepatic blood flow, thus avoiding hepatic encephalopathy.

Purpose of the Study:

  • To evaluate the efficacy and safety of the Sugiura procedure in patients with a history of variceal bleeding.
  • To assess the long-term outcomes, including recurrent bleeding, liver function, and survival rates.

Main Methods:

  • A cohort of 39 patients with previous variceal bleeding underwent the Sugiura procedure (esogastric devascularization, splenectomy, esophageal transection).
  • Patient outcomes were monitored for operative complications, postoperative complications, variceal recurrence, liver function, encephalopathy, and survival rates.

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Main Results:

  • The Sugiura procedure had no operative deaths and a low rate of severe postoperative complications (7/39 patients).
  • Endoscopic evidence showed eradication of varices in 68% of patients by the second postoperative month.
  • Recurrent variceal bleeding was prevented in 95%, 85%, and 76% of patients at 1, 3, and 5 years, respectively. No chronic hepatic encephalopathy was observed, and liver function remained stable. Survival rates at 1, 3, and 5 years were 95%, 70%, and 70%.

Conclusions:

  • The Sugiura procedure offers a low operative risk and effectively prevents recurrent variceal bleeding.
  • The procedure maintains stable liver function and poses no significant risk of hepatic encephalopathy.
  • It is recommended for patients with refractory esophageal varices who have failed medical therapy.