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Title: Abdominal Surgery in Patients With Idiopathic Noncirrhotic Portal Hypertension: A Multicenter Retrospective Study
Author: Elkrief, Laure
Ferrusquía Acosta, José
Payancé, Audrey
Moga, Lucile
Tellez, Luis
Praktiknjo, Michael
Procopet, Bogdan
Farcau, Oana
Lédinghen, Victor de
Yuldashev, Rustam
Tabchouri, Nicolas
Barbier, Louise
Dumortier, Jérôme
Menahem, Benjamin
Magaz, Marta
Hernández Gea, Virginia
Albillos, Agustín
Trebicka, Jonel
Spahr, Laurent
Gottardi, Andrea de
Plessier, Aurélie
Valla, Dominique
Rubbia Brandt, Laura
Toso, Christian
Bureau, Christophe
García Pagán, Juan Carlos
Rautou, Pierre-Emmanuel
Keywords: Hipertensió portal
Malalties del fetge
Portal hypertension
Liver diseases
Issue Date: 29-Mar-2019
Abstract: In patients with idiopathic noncirrhotic portal hypertension (INCPH), data on morbidity and mortality of abdominal surgery are scarce. We retrospectively analyzed the charts of patients with INCPH undergoing abdominal surgery within the Vascular Liver Disease Interest Group network. Forty‐four patients with biopsy‐proven INCPH were included. Twenty‐five (57%) patients had one or more extrahepatic conditions related to INCPH, and 16 (36%) had a history of ascites. Forty‐five procedures were performed, including 30 that were minor and 15 major. Nine (20%) patients had one or more Dindo‐Clavien grade ≥ 3 complication within 1 month after surgery. Sixteen (33%) patients had one or more portal hypertension–related complication within 3 months after surgery. Extrahepatic conditions related to INCPH (P = 0.03) and history of ascites (P = 0.02) were associated with portal hypertension–related complications within 3 months after surgery. Splenectomy was associated with development of portal vein thrombosis after surgery (P = 0.01). Four (9%) patients died within 6 months after surgery. Six‐month cumulative risk of death was higher in patients with serum creatinine ≥ 100 μmol/L at surgery (33% versus 0%, P < 0.001). An unfavorable outcome (i.e., either liver or surgical complication or death) occurred in 22 (50%) patients and was associated with the presence of extrahepatic conditions related to INCPH, history of ascites, and serum creatinine ≥ 100 μmol/L: 5% of the patients with none of these features had an unfavorable outcome versus 32% and 64% when one or two or more features were present, respectively. Portal decompression procedures prior to surgery (n = 10) were not associated with postoperative outcome. Conclusion: Patients with INCPH are at high risk of major surgical and portal hypertension–related complications when they harbor extrahepatic conditions related to INCPH, history of ascites, or increased serum creatinine.
Note: Versió postprint del document publicat a:
It is part of: Hepatology, 2019, vol. 70, num. 3, p. 911-924
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ISSN: 4944231
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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