Splenectomy associated with ligature of the left gastric vein in children with surgical schistosomiasis: analysis of the hepatic functional reserve
| Autor: | Oyama Arruda Frei Caneca, Carlos Teixeira Brandt, Dione Souza Tavares Maciel |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
RD1-811 Hipertensão portal medicine.medical_treatment Left gastric vein Splenectomy Serum albumin lcsh:Surgery Schistosomiasis Gastroenterology Serum bilirubin Esplenectomia Internal medicine medicine Ligature Portal hypertension Reserva funcional hepática biology Esquistosomíase mansoni business.industry Blood flow lcsh:RD1-811 medicine.disease Schistosomiasis mansoni Surgery Hepatic arterial flow biology.protein Hepatic functional reserve business |
| Zdroj: | Acta Cirúrgica Brasileira v.12 n.3 1997 Acta Cirúrgica Brasileira Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia (SBDPC) instacron:SBDPC Acta Cirurgica Brasileira, Vol 12, Iss 3, Pp 150-153 (1997) Acta Cirurgica Brasileira, Volume: 12, Issue: 3, Pages: 150-153, Published: SEP 1997 |
| Popis: | Splenectomy and ligature of the left gastric vein in children with hepatosplenic schistosomiasis mansoni and bleeding esophageal varices produce a decrease of the portal hepatic blood flow and increase in the hepatic arterial flow. The effects of these hemodinamic changes in the liver could, theoretically, deteriorate the hepatic functional reserve of these patients. Forty children with this pathology underwent that kind of treatment and they were followed-up, prospectively , mean follow up of 48 months, regard to their hepatic functional reserve. Before surgery, thirteen children were classified as "good risk - grade A" in the Child’s criteria for assessment of the hepatic reserve and twenty seven as "moderate risk - grade B". The mean serum albumin concentration was 3.16g/dl ± 0.62g/dl. Only in one patient the serum bilirubin concentration was slightly greater than 2mg/dl. After surgery, fifteen patients were diagnosed as "good risk - A" and twenty five as "moderate risk - B". The mean serum albumin concentration was 3.25g/dl ± 0.50g/dl. Similarly one patient in the post-operative follow-up has presented with serum bilirubin concentration greater than 2mg/dl. Additionally, after surgery there was a significant improvement in the plasma prothrombin levels. These findings support the idea that there has been no deterioration of the hepatic functional reserve of these patients. Foram submetidas 40 crianças, portadoras de esquistosomíase mansônica hepatoesplemica e sangramento de varizes esofágica, à esplenectomia e ligadura da veia gástrica esquerda. Foram acompanhadas durante 48 meses de pós-operatório, determinando-se a reserva funcional hepática durante esse período. Antes do tratamento cirúrgico, 13 crianças classificadas como grau A de Child's e 27 como grau B. A concentração média da albumina sérica era 3.16g/dl ± 0.62g/dl. Apenas em 1 paciente a concentração de bilirrubina sérica era pouco maior do que 2mg/dl. Após intervenção operatória, 15 pacientes foram diagnosticados como grau A de Child's e 25 como grau B. A concentração média de albumina sérica foi 3.25g/dl ± 0.50g/dl. Um paciente apresentava ainda na evolução pós-operatória concentração de bilirrubina sérica maior que 2mg/dl. Houve melhora significante após operação dos níveis de protrombina plásmica. Concluiu-se que não houve deteriorização da reserva funcional hepática nos pacientes operados. |
| Databáze: | OpenAIRE |
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