Introduction. Article is devoted to the improvement of miniinvazive surgical treatment of patients with liver cirrhosis (LC) with portal hypertension.
The aim of the work is the determination of patients with LC and portal hypertension surgical treatment effectiveness throughout the immediate and long-term postoperative period.
Material and methods. Miniinvasive operations of porto-caval shunting (PCS) were carried out for 98 patients with liver cirrhosis (LC) treatment and portal hypertension. The efficiency of surgical operations was evaluated. Portal system selective decompression was reached by distal spleno-renal anastomosis, portal system partial decompression was eliminated by porto-caval anastomosis creation. The patients were under the observation directly after the operation — within 3–6 months and during the postponed period — till 4–5 years. The number of complications and lethality cases, as well as the dynamics of the degree of varicose veins of the esophagus and the severity of portal hypertensive gastropathy, were chosen as criteria for the effectiveness of the performed operations. Authors provided indications and contraindications to PCS operations.
Results. Data of clinical observations are in favour of PKS in patients with LC which results in patients’ clinical condition improvement, encephalopathy reduction, decrease of complications episodes and lack of lethality. During immediate and delayed postoperative follow-up, patients with CP have a positive dynamics of varicose veins of the esophagus and portal hypertensive gastropathy. There were no lethality in case of such operations performing.
Conclusions. Authors conclude that both selective and partial PKS are effective methods for portal hypertension correction because it results in the main disease treatment, guarantees the esophageal and gastric bleedings prevention in the postponed period and provides survival of patients with the compensated or subcompensated liver function. Both selective and partial PKS efficacy is confirmed by varicose veins of the esophagus manifestation improvement as well as by a decrease in the number of patients with a severe intensity of this pathology. A similar positive picture as a result of portal system decompression operations in patients with LC is registered in case of portal hypertensive gastropathy severity evaluation.