Long-term results of esophagogastric devascularization and splenectomy associated with endoscopic treatment in schistosomal portal hypertension.

World Journal of Surgery
Fábio Ferrari MakdissiLuiz Augusto Carneiro D'Albuquerque

Abstract

Esophagogastric devascularization and splenectomy (EGDS) is the most performed operation for prophylaxis of esophageal varices bleeding recurrence in hepatosplenic schistosomiasis. Lower rebleeding rates are obtained through the association of postoperative endoscopic treatment; however, there is a dearth of studies showing long-term results. Clinical, laboratory, and endoscopic data of 97 patients submitted to EGDS with at least 5 years of follow-up, were analyzed. The mean follow-up was 116.4 months. Bleeding recurrence occurred in 24.7% of patients; however, this percentage was 14.6% when only variceal hemorrhage was considered. Bleeding recurrence occurred in four patients even after endoscopic evaluation demonstrated esophageal varices eradication. In the late follow-up we observed normalization of anemia, leukopenia, thrombocytopenia, hyperbilirubinemia, and a prothrombin activity time increase. No clinical or laboratory hepatic insufficiency was observed. The EGDS procedure with postoperative endoscopic treatment led to good clinical results and avoided hemorrhagic recurrence in 75.3% of schistosomal patients. There was improvement of laboratory measures of hepatic function, as well as correction of hypersplenism. Varice...Continue Reading

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Citations

Apr 19, 2011·Surgery·Wellington AndrausLuiz Augusto C D'Albuquerque
Aug 13, 2015·PloS One·Luiz Arthur Calheiros LeiteVera Lucia de Menezes Lima
Sep 24, 2016·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Renata P ColaneriPaulo Herman
Nov 6, 2015·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Walter De Biase da Silva-NetoThiago Miranda Tredicci
Jul 9, 2014·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Fabricio Ferreira CoelhoPaulo Herman
Dec 4, 2014·World Journal of Gastroenterology : WJG·Renata Potonyacz ColaneriPaulo Herman
May 4, 2011·Revista do Colégio Brasileiro de Cirurgiões·Alvaro Antônio Bandeira FerrazEdmundo Machado Ferraz
Nov 6, 2013·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Fabio Gonçalves Ferreira
May 25, 2013·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·João Batista-NetoElton Elton Correa Alves
Jun 3, 2015·World Journal of Gastroenterology : WJG·Guilherme Lopes P MartinsMarcos Roberto Menezes
Feb 11, 2014·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Fernanda Maria Fernández PereiraCláudio Moura Lacerda
Feb 5, 2021·Transactions of the Royal Society of Tropical Medicine and Hygiene·Guilherme G L CançadoLuciana C Faria
Mar 26, 2021·PLoS Neglected Tropical Diseases·Francesca TamarozziFederico G Gobbi

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