Novosti
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Year 2012 Vol. 20 No 4
GENERAL AND SPECIAL SURGERY
P.K. KHOLMATOV, U.A. KURBANOV, N.U. USMANOV
RESULTS OF PORTOSYSTEMIC SHUNTING AT PORTAL HYPERTENSION
Tajik Abu Ali Ibn Sino State Medical University ,
The Republic of Tajikistan
Objectives. To study the immediate results of portosystemic shunting in patients with the portal hypertension.
Methods. The treatment results of 41 patients with the portal hypertension (PH) were studied: 17 patients with A class, 24 patients with B class according to the classification of Child – Pugh. Splenorenal anastomosis was made side by side in 14 patients, the distal splenorenal shunting – in 11, the splenorenal anastomosis with the upper interlobar vein of the left kidney with splenectomy – in 2, the splenorenal anastomosis and splenectomy - in 10 cases and the mesocaval anastomosis – in 4 cases.
Results. Esophageal varicosity of the I grade was revealed in 6 (14,6%), of the II grade – in 14 (34,29%) and of the III grade – in 21 (51,2%) patients. Patients with the liver cirrhosis (functional class A) having an initial degree of esophageal varicosity revealed the expansion of the splenic vein (VESV) up to 0,86±0,21 cm and a moderate enlargement of the spleen up to 12,9±2,5 cm. The high-speed parameters in the portal system veins in this group is appeared to reduce. In patients with the liver cirrhosis (functional class B) and marked VESV one registered the following: a more pronounced expansion of the splenic vein 0,98±0,17 cm, splenomegaly, in 14 (58,3%) patients the blood flow was registered in the periomphalic vein. In the early postoperative period after the splenorenal anastomosis performance combined with splenectomy gastro-esophageal bleeding has developed in 3 patients. The portosystemic shunt was successful in 38 patients.
Conclusions. Surgical correction with the performance of various portosystemic anastomoses in A and B class patients according to the classification of Child – Pugh at esophageal varicosity of the II-III grades is considered to be an effective method of prevention and treatment of the gastro-esophageal bleeding.
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734003, Respublika Tadzhikistan,Dushanbe, prospekt Rudaki, d. 139,Tadzhikskiy gosudarstvennyiy meditsinskiyuniversitet im. Abuali ibni Sino,kafedra hirurgicheskih bolezney ¹1
e-mail: egan0428@mail.ru,
Holmatov Pulat Kadyirovich
Kholmatov P.K., Candidate of Medical Sciences, Associate Professor of the Surgical Diseases Chair ¹1 of Tajik Abu Ali Ibn Sino State Medical University
Kurbanov U.A., Doctor of Medical Sciences, Professor, Rector of Tajik Abu Ali Ibn Sino State Medical University
Usmanov N.U., Academician of the Academy of Sciences of Tajikistan, Professor of The Surgical Diseases Chair ¹2 of Tajik Abu Ali Ibn Sino State Medical University.
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