Volume : VIII, Issue : VIII, August - 2019

Outcome of Proximal splenorenal shunt in Extra hepatic portal vein obstruction

Ramamurthy C, Sugumar C, Jeswanth S, Prabakaran R, Senthilkumar P, Kamalakannan R, Saravanan J, Thiruvarul M

Abstract :

Introduction : EHPVO and NCPF are common cause of non cirrhotic portal hypertensionwhich accounts for 40% of Portal hypertension in developing countries.The aim of this study is to analyze the clinical presentation, management of patients with EHPVO treated with surgical shunt, devasculararisation and endotherapy and outcome of these treatment modalities at our institute. Materials and methods : This study is a retrospective analysis of patients with EHPVO admitted at our institute during the period from January 2009 to december 2018. Clinical presentation, etiology of EHPVO, laboratory and radiological workup, endoscopic findings and management,outcome and follow up details were analyzed. Results : During the study period, among 52 EHPVO patients diagnosed, 70% of patients belong to 15 – 30 years of age. 90% presented with variceal bleeding and 35% with portal cavernomacholangiopathy of which 44% being symptomatic. In our study, 50 % (26/52) patients underwent proximal splenorenal shunt, 26%(14/52) patients managed with endotherapy and 23% (12/52) patients underwent Splenectomy with esophagogastricdevascularisation procedure because of unavailability of shuntable vein. Mean splenic vein diameter and shunt diameter was 9.8 mm and median fall in portal pressure was 13 mm of Hgin patients who underwent PSRS. Variceal regression rate was 92% in PSRS patients and regression to obliterated varices from grade III is 80% with PSRS group whereas 67% in devasculararisation group. Rebleeding rate was 17% in devasculararisation group versus no rebleeding in PSRS group.Portal biliopathy could be reversed with PSRS in 94% of patients. Conclusion : In EHPVO, Proximal splenorenal shunt is the good treatment option to prevent rebleeding , to treat hypersplenism and to reverse biliopathy.

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Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

OUTCOME OF PROXIMAL SPLENORENAL SHUNT IN EXTRA HEPATIC PORTAL VEIN OBSTRUCTION, Ramamurthy C, Sugumar C, Jeswanth S, Prabakaran R, Senthilkumar P, Kamalakannan R, Saravanan J, Thiruvarul M INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-8 | Issue-8 | August-2019

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