Detailed Abstract
[Poster Presentation 11 - Liver (Liver Disease/Surgery)]
[LV PP 11-S2] “Non-Cirrhotic Portal Hypertension(NCPH): Demographic , Clinicopathological, Short And Long Term Outcome of Shunt Surgery – PSRS- a Tertiary Care Hospital Experience in Eastern India (Odisha) ”
Dr. Swamy Rajesh HUDUGUR 1, Dr. Satyaprakash Ray CHUDHURY 1, Dr. Jyotirmay JENA 1, Dr. Sumit S MOHANTY 1
1 Department of Surgical Gastroenterology , IMS & SUM Hospital , INDIA
Background : NCPH includes extrahepatic portal vein obstruction (EHPVO) and non cirrhotic portal fibrosis (NCPF).Shunt surgery is commonly indicated in endoscopically refractory varices, symptomatic hypersplenism, severe thrombocytopenia, Portal biliopathy. PSRS is most commonly performed Aims : To study Demographic , clinicopathological & short term and long term Surgical outcomes in patients who underwent PSRS .
Methods : All patients diagnosed as NCPH between January 2016 and December 2022 at IMS&SUM Hospital,Bhubaneshwar were retrospectively reviewed. patients who underwent PSRS procedure were evaluated postoperatively using clinical, laboratory parameters, Ultrasound Doppler and dynamic CT Portography.
Results : Of 66 patients (49(74.2%) EHPVO, 17(25.7%) NCPF), mean age 27.15±7.72years, 38 males and 28 females. Mc symptom was UGI bleed (Hematemesis(33). On endoscopy, 55(83.3%) patients had esophageal varices, Among 54 patients who underwent surgery, 38(69.1%)proximal splenorenal shunt(PSRS), 6(10.9%)had splenectomy with devascularization(SD), and 10(18.2%) had only splenectomy(OS). Mc Indications for surgery was variceal bleeding(VB) requiring multiple EVL(81.8%,n=45). Major complications affected 10.9%(n=6). Over 41.9±15.27months' mean follow-up. Of shunted patients, patent shunts and complete variceal regression occurred in 30. Shunt patency rate using ultrasound Doppler and dynamic CT portography 90% and 80% respectively after 1 year and decreased to 85% and 70% after 2 years.
Conclusions : Conclusion: In Post PSRS patients short term outcome is good while shunt patency rate decreases over time - 91.6%,89.28%,80% at 1year,3 &5 year respectively. Dynamic CT portography is useful modality for assessment of shunt patency in early and late postoperative periods. PSRS caused marked resolution (80%) of portal biliopathy symptoms. SD is acceptable alternative where shunt is not feasible.
Methods : All patients diagnosed as NCPH between January 2016 and December 2022 at IMS&SUM Hospital,Bhubaneshwar were retrospectively reviewed. patients who underwent PSRS procedure were evaluated postoperatively using clinical, laboratory parameters, Ultrasound Doppler and dynamic CT Portography.
Results : Of 66 patients (49(74.2%) EHPVO, 17(25.7%) NCPF), mean age 27.15±7.72years, 38 males and 28 females. Mc symptom was UGI bleed (Hematemesis(33). On endoscopy, 55(83.3%) patients had esophageal varices, Among 54 patients who underwent surgery, 38(69.1%)proximal splenorenal shunt(PSRS), 6(10.9%)had splenectomy with devascularization(SD), and 10(18.2%) had only splenectomy(OS). Mc Indications for surgery was variceal bleeding(VB) requiring multiple EVL(81.8%,n=45). Major complications affected 10.9%(n=6). Over 41.9±15.27months' mean follow-up. Of shunted patients, patent shunts and complete variceal regression occurred in 30. Shunt patency rate using ultrasound Doppler and dynamic CT portography 90% and 80% respectively after 1 year and decreased to 85% and 70% after 2 years.
Conclusions : Conclusion: In Post PSRS patients short term outcome is good while shunt patency rate decreases over time - 91.6%,89.28%,80% at 1year,3 &5 year respectively. Dynamic CT portography is useful modality for assessment of shunt patency in early and late postoperative periods. PSRS caused marked resolution (80%) of portal biliopathy symptoms. SD is acceptable alternative where shunt is not feasible.
SESSION
Poster Presentation 11
Zone E 3/22/2024 2:50 PM - 3:40 PM