EXTRA-HEPATIC PORTAL OBSTRUCTION - CLINICAL-EXPERIENCE AND SURGICAL-TREATMENT IN 105 PATIENTS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 21  (4) , 439-448
Abstract
The incidence of portal thrombosis is similar to other reports, but there is recent evidence of an increase of idiopathic adult onset and post-cirrhotic vs. childhood onset extrahepatic portal obstruction. Patients (105) or 24.6% of a 426 series of patients operated upon for portal hypertension, suffered from an extra-hepatic block (52.4% pre-hepatic and 47.6 mixed post-cirrhotic obstruction). The total series of patients were classified according to portal involvement degree: 47.6% had portal, 46.7% massive porto-radicular and 5.8% radicular obstruction. Physiopathologic differences were found among patients with acute, recanalized or recurrent thrombosis. The clinical picture in massive or post-cirrhotic block was generally more severe, due to repeated massive and life threating digestive hemorrhages. The width of portal tree involvement proportionally affects the possibility of surgical management, with particular regard to shunting procedures. These seem more effective than disconnecting operations in avoiding bleeding recurrences and warranting a better long term survival.

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