Prognostic criteria of variceal bleeding in patients with portal hypertension

Жигалова, С. Б.; Manukian, Gregor; Шерцингер, А. Г.; Фандеев, Е. Е.; Семенова, Т. С.; Коршунов, И. Б.; Мартиросян, Р. А.

doi:10.16931/1995-5464.2018476-85

Cited by 8 publications

(2 citation statements)

References 6 publications

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“…Пациенты групп сравнения сопоставимы по степени печеночной недостаточности и степени расширения вен. В обеих группах при видеогастроскопии определялись ВРВП III степени по Щерцингеру [11][12][13]. Исходя из выше приведенных результатов операций сроки госпитализации при ЭЛ ВРВП значительно сократилось, до 8,30 ± 2,27 дня, в сравнении с 17,00 ± 5,71 дня после операции Пациоры, учитывая мини-инвазивность при выполнении ЭЛ ВРВП и отсутствие необходимости общей анестезии в купе значительно сокращает время операции: 16 ± 4,81 минуты при лигировании и 84 ± 21,42 при операции Пациоры.…”

Section: Discussionunclassified

Endoscopic Prophylaxis and Treatment of Portal-Genesis Oesophageal Haemorrhage

Bebezov

Sultangaziev

Abdykadyrov

2022

Kreativnaâ hirurgiâ i onkologiâ

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Background. Portal hypertension-triggered oesophageal and gastric variceal bleeding is the most dangerous and threatening complication, with an up to 50–70 % mortality at first episode. High-mortality repeated bleeding develops subsequently in 30–50 % patients, with the proved 100 % recurrence rate in the first two years following the first episode. The world experience dictates further research to continue towards developing new surgical methods and approaches.Aim: to evaluate the treatment efficacy of pneumatic endoscopic band ligation of bleeding oesophageal varices (OV).Materials and methods. The experience of applying pneumatic endoscopic ligation treatment in the patients managed at the General Surgery Unit of the Clinical Hospital of the Kyrgyz Republic Presidential Administration during 2017–2019 was analysed. Endoscopic ligation is a modern minimally invasive and less traumatic intervention used to markedly reduce mortality and improve quality of life in patients with portal hypertension syndrome. The evidence on 76 patients following endoscopic OV ligation was summarised. The patient age ranged from 11 to 70 years (mean 46.26 years); 40 men (52.6 %) and 36 women (47.4 %) were included. Among the 76 patients, portal hypertension was caused by viral cirrhosis in 38, hepatitis B in 5, delta agent hepatitis B in 18, hepatitis C in 13, a hepatitis B–C combination in 1 and a delta agent hepatitis B — hepatitis C combination in 1 patient. In 21 patients, cirrhosis was of unknown aetiology. A portal vein malformation was observed in 13 people of whom 4 had it combined with thrombosis.Results. A total of 94 ligation procedures were performed in 76 patients with grade II–III OV. Some patients needed to undergo the procedure several times, 18 patients had 2 sessions. Two cases required 3 and 4 sessions each. Moderate oesophageal soreness was reported in 32 patients for 1–6 days following the ligation. No complications were registered during the operation. In early postoperative period, 2 patients developed recurrent bleeding, with haemostasis re-achieved by a repeated vein ligation below bleeding.Conclusion. Hence, small invasiveness and minor traumatism coupled with high efficiency and lesser complications render endoscopic ligation the method of choice in primary and secondary prophylaxis and treatment of OV. Endoscopic ligation improves the patient’s quality of life, allows an extra time for conservative treatment and longer period to liver transplantation.

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Section: Discussionunclassified

Endoscopic Prophylaxis and Treatment of Portal-Genesis Oesophageal Haemorrhage

Bebezov

Sultangaziev

Abdykadyrov

2022

Kreativnaâ hirurgiâ i onkologiâ

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“…В зависимости от уровня препятствия току крови различают подпечёночную, внутрипечёночную, надпечёночную портальную гипертензию [5,6]. Очевидно, способы моделирования для каждого из этих вариантов свои, однако, в плане технической сложности они не равнозначны.…”

Section: результатыunclassified

Method for increasing scientific value of portal hypertension modeling experiment

Федосеев

Budarev

Chekushin

2023

jour

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Aim: development and testing of a technically simple method for the formation of portal hypertension in the body of a domestic pig, which makes it possible to obtain a model that is close in key parameters to humans. Materials and methods. The material of the study was the results of an experiment conducted in the vivarium of the Ryazan State Medical University on 12 domestic pigs. Results. A method for modeling portal hypertension in the body of a domestic pig by dosed compression of the hepatoduodenal ligament with a plastic clamp was developed and tested. Conclusions. A model of portal hypertension was obtained, which makes it possible to obtain scientific data easily extended to humans, due to the similarity of the anatomy, physiology, and size of the used laboratory animal with those of humans.

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Portosystemic shunting procedures for complicated portal hypertension: modern opportunities of mini-invasive technique

et al. 2021

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Aim. To improve the results of treatment for patients with complicated portal hypertension of cirrhotic genesis using the transjugular intahepatic portosystemic shunt with endovascular obliteration of the inflow pathways to the esophageal-gastric varicose veins.Material and methods. Transjugular intahepatic portosystemic shunt was performed in 172 patients with gastroesophageal variceal bleeding. The patients were divided into 3 clinical groups. The shunting procedure was applied to 62 patients. Another 110 patients underwent transjugular intahepatic portosystemic shunt and selective obliteration of the esophageal-gastric vein inflow pathways. The short-term and long-term results (up to 140 months), the incidence of thrombosis, recurrent bleeding and mortality, as well as their relationship with the established risk factors for complications were traced.Results. All patients achieved an effective reduction in the portosystemic pressure gradient and a reduction in the manifestations of portal hypertension. Recurrence of bleeding caused by shunt thrombosis occurred in 23 (13.3%) patients. In clinical group I (n = 62), this complication was noted in 9 (14.5%) patients, in II (n = 54) – 11 (20.4%) cases, in III (n = 56) – only in 3 (5.4%) cases. Bleeding-free survival decreased from 1.0 to 0.82 in 83.9 months, then plateaued. A sharp decrease in the Kaplan–Meier curve from 1.0 to 0.88 was observed within 24.5 months after the intervention. The largest number of deaths was in group I (30.6%), the smallest in group III (7.1%).Conclusion. Transjugular intahepatic portosystemic shunt supplemented by obliteration the inflows of the esophagealgastric varicose veins provides complete eradication of varicose veins, helps to reduce the frequency of recurrent bleeding and death.

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Prognostic criteria of variceal bleeding in patients with portal hypertension

Cited by 8 publications

References 6 publications

Endoscopic Prophylaxis and Treatment of Portal-Genesis Oesophageal Haemorrhage

Endoscopic Prophylaxis and Treatment of Portal-Genesis Oesophageal Haemorrhage

Method for increasing scientific value of portal hypertension modeling experiment

Portosystemic shunting procedures for complicated portal hypertension: modern opportunities of mini-invasive technique

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