Year 2013 Vol. 21 No 4




Republican Specialized Center of Surgery named after academician V.Vahidov
The Republic of Uzbekistan

Objectives. To study the peculiarities of the complications of liver cirrhosis (LC) depending on the etiological factors and to analyze the results of portosystemic shunting (PSSh) in these groups of patients.
Methods. The analysis covered the results of the PSSh in 309 cirrhotic patients with LC and portal hypertension (PH). All patients were divided into 4 groups: hepatitis B, C, HBV + HDV and chronic alcoholism.
Results. The performed analysis showed that for HBV-cirrhosis and especially for its combination with HDV-infection, a high incidence of clinically diagnosed hepatic encephalopathy and ascitic syndrome are considered to be the most typical. In turn, in case of HCV-cirrhosis and negative viral markers the risk of bleeding from the esophageal and gastric varices (EGV) predominates.
Conclusions. For HBV-cirrhosis and particularly for its combination with HDV-infection, high frequency of clinically diagnosed hepatic encephalopathy (24,7% and 33,3%) and ascitic syndrome (65,9% and 71,8%) are considered to be the most typical, while the incidence of bleeding from EGV is 53,8% and 56,4%, respectively. In turn, if HCV-cirrhosis and negative viral markers, clinical stages of hepatic encephalopathy detected in 18,9% and 20%, ascites in 47,2% and 45,7%, but the risk of bleeding reaches 71,7% and 51,4%, respectively. In cirrhotic patients HBV and HBV+HDV-etiology after PSSh the highest risk of developing liver failure (9,9-15,4%) and encephalopathy (63,4-84,2%) has been registered and the mortality rate reaches 3,3-5,1%. In case of HCV etiology cirrhosis surgery also contributes to poor functional status of hepatocytes, but the development of liver failure and encephalopathy is observed 1,5-2 folds rarely than in case of HBV and HBV + HDV-cirrhosis.

Keywords: viral hepatitis, liver cirrhosis, portal hypertension, bleeding from esophageal and gastric varices, portosystemic shunting
p. 45 50 of the original issue
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Address for correspondence:
100115, Respublika Uzbekistan, g. Tashkent, ul. Farkhadskaia, d. 10, Respublikanskii spetsializirovannyi tsentr khirurgii im. akad. V. Vakhidova, otdelenie khirurgii portal'noi gipertenzii i pankreatoduodenal'noi zony,
Babadzhanov Azam Khasanovich
Information about the authors:
Raimov S.A. An applicant for Doctors degree of the department of portal hypertension and pancreatoduodenal zone, Republican Specialized Center of Surgery named after academician V. Vahidov.
Babadzanov A.H. PhD, a senior researcher of the department of portal hypertension and pancreatoduodenal zone, Republican Specialized Center of Surgery named after academician V. Vahidov.
Devyatov A.V. MD, professor, a chief researcher of the department of portal hypertension and pancreatoduodenal zone, Republican Specialized Center of Surgery named after academician V. Vahidov.
Nazyrov F. G. Honored Worker of Public health care of the Republic of Uzbekistan, MD, professor, Academician of the Russian Academy of Natural Sciences, director of Republican Specialized Center of Surgery named after academician V. Vahidov, a head of the department of surgery of liver, biliary ducts, pancreatoduodenal zone and portal hypertension, vice-president of the Association of surgeons- hepatologists of CIS.
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