The influence of periportal (pipestem) fibrosis on long term results of surgical treatment for schistosomotic portal hypertension

Ferraz, A.; Albuquerque, Pedro Cavalcanti de; Lopes, Edmundo Pessoa; Araújo, José Guido Corrêa de; Carvalho, Anderson Henrique Ferreira; Ferraz, Edmundo Machado

doi:10.1590/s0004-28032003000100002

Cited by 19 publications

(18 citation statements)

References 14 publications

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“…In the present issue of ARQUIVOS de GASTROENTE-ROLOGIA, FERRAZ et al (11) have reported similar results studying histological abnormalities of wedge liver biopsies obtained during EGDS in patients with SPH and comparing the degree of periportal fibrosis with recurrence of hemorrhage from EV. The same authors have previously reported their results encouraging EGDS combined to postoperative sclerotherapy in subjects with residual EV (9,10) as the treatment of choice for secondary prevention of bleeding from EV in schistosomiasis.…”

supporting

confidence: 60%

“…The same authors have previously reported their results encouraging EGDS combined to postoperative sclerotherapy in subjects with residual EV (9,10) as the treatment of choice for secondary prevention of bleeding from EV in schistosomiasis. In this study, subjects submitted to EGDS with periportal fibrosis grade I had significantly less rebleeding when compared to their counterparts with grade II or III (3% vs. 21% and 16%, respectively) (11) .…”

mentioning

confidence: 53%

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Portal fibrosis and schistosomal portal hypertension: what is the best strategy for primary and secondary prevention of hemorrhage from esophageal varices

Bittencourt

2003

Arq. Gastroenterol.

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confidence: 60%

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confidence: 53%

Portal fibrosis and schistosomal portal hypertension: what is the best strategy for primary and secondary prevention of hemorrhage from esophageal varices

Bittencourt

2003

Arq. Gastroenterol.

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“…It may cause lower gastrointestinal bleeding or unidentified chronic anemia in patients with severe portal hypertension (4,11,14) . Splenectomy and gastric devascularization, one of the recommended surgical treatments for gastrointestinal bleeding in patients with hepatosplenic schistosomiasis, reduces portal pressure by around 30%, as also the blood flow to the territory of the esophageal varices while preserving liver function (3,5,6,12,16) . The effect of such surgery on PHC is unclear.…”

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confidence: 99%

Improvement of Schistosomal Portal Hypertensive Colopathy After Surgical Treatment

Miranda

Ferraz

Domingues³

et al. 2013

Arq. Gastroenterol.

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-Context -Data on vascular alterations in patients with hepatosplenic schistosomiasis and portal hypertensive colopathy and changes in these after surgery to decrease portal hypertension are limited. Objective -The purpose of this study was to analyse the alterations of portal hypertensive colopathy previously and 6-12 months after splenectomy and gastric devascularization. Methods -Twelve patients with hepatosplenic schistosomiasis who also had upper gastrointestinal bleeding were studied prospectively. Their endoscopic findings before and 6-12 months after the surgery were analysed. In addition, mucosal biopsies from ascending colon, sigmoid colon and rectum at these time points were subjected to histological and histomorphometric assessment. It was used a control group due to lack of normal pattern of the histomorphometric measures of vessels in individuals without portal hypertension. The critical level of significance adopted in all tests was of a maximum probability error of 5%. Results -Surgery did not lead to significant improvement in histological and endoscopic findings. However, on histomorphometry, there was a significant decrease in the area, diameter and thickness of the vessels in mucosa at all colonic sites. Conclusion -Surgery for decompression of schistosomal portal hypertension has a beneficial effect on the associated colopathy, being best indicated in patients with gastrointestinal bleeding and esophageal varices. HEADINGS -Hypertension, portal. Schistosomiasis mansoni. Colonic diseases. Microvascular descompression surgery.

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“…Surgical treatment of schistosomal portal hypertension by splenectomy with ligation of left gastric vein, followed by postoperative endoscopic sclerosis is indicated in cases associated with prior upper gastrointestinal bleeding due to rupture of esophageal varices and/or gastric ulcers, or in cases of hypersplenism with important clinical consequences for the patient 1 In an attempt to identify risk factors that may compromise the postoperative outcome of patients undergoing surgery for disconnection and splenectomy, several authors have tried to preoperatively identify parameters that can improve late results in this group of patients, mainly with respect to rebleeding [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] .…”

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confidence: 99%

Influência da inversão do diâmetro veia porta/veia esplênica nos resultados do tratamento cirúrgico da hipertensão portal esquistossomótica

Aa¹,

et al. 2011

Rev. Col. Bras. Cir.

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Results: 169 patients were analyzed, with follow-up averaging 23.6 months. Twenty-one patients (12.4%) had splenic vein caliber greater of equal than the portal vein's (Inversion -study group). The mean preoperative diameter of the portal and splenic veins were respectively 1.49 and 1.14 cm in the control group, and 0.98 versus 1.07 cm in the inversion group. The portal vein diameter was significantly higher in the control group when compared to the inversion group (p <0.05). Varices in the gastric fundus were found in 33.3% of the inversion group and in 38.5% of patients in the control group. Postoperative rebleeding occurred in 23.1% of patients in the inversion group and in 13.4% of the control group ones (p> 0.05). In the postoperative evaluation with Doppler ultrasonography of portal vessels, no cases of portal vein thrombosis were observed in the inversion group, whilst in the control group portal thrombosis was identified in 16.9% of the patients (p <0.05). Death occurred in one (4.8%) individual from the inversion group; mortality was 4.1% in the control group (p>0.05). The mean serum level of platelets was significantly lower (65,950/mm³) in the inversion group than in the controls (106,647/mm³) (p<0.05). Conclusion: Conclusion: Conclusion: Conclusion: Conclusion: The results suggest that the reversal of portal/splenic vein caliber ratio does not represent a contraindication to surgical treatment of schistosomal portal hypertension.

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The influence of periportal (pipestem) fibrosis on long term results of surgical treatment for schistosomotic portal hypertension

Cited by 19 publications

References 14 publications

Portal fibrosis and schistosomal portal hypertension: what is the best strategy for primary and secondary prevention of hemorrhage from esophageal varices

Portal fibrosis and schistosomal portal hypertension: what is the best strategy for primary and secondary prevention of hemorrhage from esophageal varices

Improvement of Schistosomal Portal Hypertensive Colopathy After Surgical Treatment

Influência da inversão do diâmetro veia porta/veia esplênica nos resultados do tratamento cirúrgico da hipertensão portal esquistossomótica

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