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      Reoperations for Bleeding Portal Hypertension. Surgical Rescue of Surgical Failures

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          Abstract

          Background; Surgery for portal hypertension has a low rebleeding rate. Patients that rebleed can be grossly divided into those who die as a consequence of the episode, those who don't die but develop liver failure (remaining as Child-Pugh C) and those who, in spite of the bleeding episode, retain good liver function (Child-Pugh A or B). At our hospital, the latter group is considered for further surgical treatment. We report here the results of surgical rescue of surgical failures.

          Methods; In a twenty year period, 36 patients (30 Child-Pugh A, 6 Child-Pugh B) were reoperated. The files of these patients were reviewed.

          Results; Average age was 33 years. Cirrhosis was present in 31 cases. All patients were electively reoperated with portal blood flow preserving procedures. Operative mortality for the whole group was 12% and for the Child-Pugh A group 6.6%. Rebleeding was observed in 5.5%. Postoperative incapacitating encephalopathy was recorded in one case (2.7%). Good quality of life was recorded in 84% of the cases. Survival (Kaplan-Meier) was 78% at 6 months and 69% at 5 years.

          Conclusions; Surgical failures in low risk patients (Child-Pugh A or B) can be treated by means of surgery, and a low mortality, re-bleeding and encephalopathy rate can be expected. The performance of a portal blood flow preserving procedure is recommended.

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          Author and article information

          Affiliations
          [ ] Portal Hypertension Clinic Instituto Nacional de la Nutrición Salvador Zubirán Vasco de Quiroga 15 México, D.F. Tlalpan 14000 Mexico
          Journal
          HPB Surg
          HPB Surgery
          Hindawi Publishing Corporation
          0894-8569
          1607-8462
          April 1999
          : 11
          : 3
          : 151-155
          2423974
          10371059
          S0894856999734144
          10.1155/1999/73414
          Copyright © 1999 Hindawi Publishing Corporation.

          This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

          Categories
          Research Article

          Surgery

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