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Modified Sugiura's procedure may improve liver function in portal hypertension
E C Tsimoyiannis1, K J Gossios, E V Tsianos
1Department of Surgery, G. Hatzikosta General Hospital, Ioannina, Greece.
Background/Aims:
Sugiura procedure is an alternative in the treatment of the bleeding gastroesophageal varices. The postoperative alterations of CT and biochemical features versus pre-operative levels in patients operated on for haemorrhagic portal hypertension were studied.
Material And Methods:
Eight patients with liver cirrhosis and portal hypertension who underwent emergency or elective modified Sugiura's operation, were included in this study. The hepatic function and the CT scan ratio of transverse caudate lobe width to transverse right lobe width, pre-operatively and during the early and late postoperative period were studied.
Results:
The hepatic function was aggravated during the immediate postoperative period but was remarkably improved, versus pre-operative status, after the first 15-30 postoperative days. The caudate to right lobe ratio from 0.66-1.7 pre-operatively, decreased to < 0.65 in all cases after the first postoperative month or year. One patient died on the 64th postoperative day from progressive hepatic failure, while all tests of the first postoperative month follow-up were improved. Another patient presented a light rebleeding 4 years after operation, while the hepatic tests were average.
Conclusions:
The modified Sugiura's procedure is an effective procedure in the disappearence of the oesophageal varices, followed by low mortality and low recurrent bleeding, but it mainly leads to an improvement of the hepatic function, probably due to improved hepatic portal blood flow.