+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Clinical analysis of pericardial devascularization by preserving vagus trunks in 42 patients with portal hypertension

, : Clinical analysis of pericardial devascularization by preserving vagus trunks in 42 patients with portal hypertension. Asian Journal of Surgery 27(2): 108-113

Pericardial devascularization (PD) is less of a burden and provides better bleeding control to patients compared to shunt procedures, and so has been widely used in portal hypertension in China. However, because the vagus trunks are interrupted during surgery, patients easily suffer from postoperative stomach adynamia. Based on our understanding from autopsy of the path of vagus trunks along the distal oesophagus, we designed the operative procedure of PD by preserving vagus trunks (PDPVT) to treat portal hypertension. Between May 1991 and January 2003, patients with portal hypertension were treated surgically using PDPVT (n = 42), single PD (n = 32), or PD with pyloroplasty (PD+PP; n = 16). Operative mortality was 2.4% in the PDPVT group and 6.3% in both the PD and PD+PP groups (p > 0.05). The postoperative rebleeding rate was 9.5% in the PDPVT group and 12.5% in both the PD and PD+PP groups (p > 0.05). There were no differences in operative time and estimated blood loss between the three groups (p > 0.05). The recovery time for gastroenteric function was shorter with PDPVT (mean, 3.5 days) than with PD (mean, 5.7 days) and PD+PP (mean, 4.2 days; p < 0.02). Incidences of early satiety and enterogastric reflux were significantly lower in the PDPVT group (both 4.8%) than in the PD group (46.9% and 18.8%) and PD+PP group (12.5% and 100%; p < 0.005). Incidences of retention of gastric juice, diarrhoea and late gallstones were 12.5%, 15.6% and 7.1%, respectively, in the PD group, and 12.5%, 18.8% and 6.3%, respectively, in the PD+PP group, but none of these were observed in the PDPVT group. Since it preserves vagus trunks, PDPVT can maintain normal stomach dynamics and physiological function of hepatobiliary and gut systems better than PD and PD+PP, thus reducing incidences of postoperative complications. Thus, PDPVT is superior to PD and PD+PP in the treatment of portal hypertension.


PMID: 15140661

DOI: 10.1016/S1015-9584(09)60322-5

Other references

Foddy, B.; Savulescu, J., 2006: Addiction and autonomy: can addicted people consent to the prescription of their drug of addiction?. It is often claimed that the autonomy of heroin addicts is compromised when they are choosing between taking their drug of addiction and abstaining. This is the basis of claims that they are incompetent to give consent to be prescribed heroin. We...

Marchisio, P.; Chonmaitree, T.; Leibovitz, E.; Lieberthal, A.; Lous, J.; Mandel, E.; McCormick, D.; Morris, P.; Ruohola, A., 2013: Panel 7: Treatment and comparative effectiveness research. Otitis media (OM) is one of the most common reasons for antibiotic treatment in children. Controversies regarding antibiotic treatment for OM have accumulated in the past decade, and there seem to be more dilemmas than certainties. The objectives...

Levesque, J.P.erre; Hendy, J.; Takamatsu, Y.; Williams, B.; Winkler, I.G.; Simmons, P.J., 2001: VCAM-1 cleavage and release of neutrophil serine proteases elastase and cathepsin G in the bone marrow are common features of hemopoietic progenitor cell mobilization induced by G-CSF or chemotherapy. In adults, hematopoietic stem cells (HSC) reside in the bond marrow (BM) but can be mobilized into the peripheral blood (PB) following treatment with G-CSF or chemotherapy. In a previous work, we have shown that in vivo the expression of VCAM-1, a...

Buschman, L.L.; Sloderbeck, P.E.; Wildman, L., 1995: Second generation European corn borer control, 1994. Burditt, A K , Jr [Editor] Arthropod Management Tests 163-164

Lund, J.; Troeberg, L.; Kjeldal, H.; Olsen, O.H.; Nagase, H.; Sørensen, E.S.; Stennicke, H.R.; Petersen, H.H.; Overgaard, M.T., 2015: Evidence for restricted reactivity of ADAMDEC1 with protein substrates and endogenous inhibitors. ADAMDEC1 is a proteolytically active metzincin metalloprotease displaying rare active site architecture with a zinc-binding Asp residue (Asp-362). We previously demonstrated that substitution of Asp-362 for a His residue, thereby reconstituting th...

Harris, R.; Jones, H.P., 1970: Polyarteritis nodosa in identical twins. Annals of Physical Medicine 10(5): 241-242

Weinstein, J.J.; Rattner, H., 1962: Herbert RATTNER. Archives of Dermatology 85: 575-577

Miyamoto, K.; Matsui, H.; Tomizawa, K.; Moia, L.J.M.P.; Nishio, H.; Tokuda, M.; Itano, T.; Hatase, O., 1993: Developmental study by protein, mRNA level and physiological significance of testis specific calcineurin. Japanese Journal of Physiology 43(SUPPL 2): S40

Aberg, B., 1957: Studies on plant growth regulators. XII. Monosubstituted phenoxyacetic acid. The following monosubstituted phenoxyacetic acids - o, m and p-chloro, bromo, methyl, methoxy and nitro; p-iodo, fluoro, ethyl, tertiary butyl and isopropyl; and phenoxyacetic acid and p-phenylene-bis (oxyacetic acid) were tested on flax and wheat...

Anonymous, 1993: Society for Psychophysiological Research. 33rd annual meeting. October 27-31, 1993. Rottach-Egern, Germany. Abstracts. Psychophysiology 30 Suppl 1: S1-73