Long-term Prognostic Evaluation of Non-shunt Operation for Portal Hypertension

Abstract

We attempted to determine prognostic factors by comparison of cumulative survivals in each clinical factors in 605 patients with esophagogastric varices who underwent non-shunt operation such as esophageal transection and Hassab's operation. Univariate analysis revealed that sex, severity of liver function as assessed according to the Child's classification, timing of operation, postoperative bleeding and complicated hepatocellular carcinoma significantly influenced prognosis. By multivariate analysis, however, only severity of liver function and hepatocellular carcinoma were found to be significant independent prognostic factors. Therefore, postoperative bleeding is not a significant prognostic factor in non-shunt operation. The non-shunt operation may be superior to endoscopic treatment because bleeding from residual and recurrent varices, which often influences prognosis in endoscopic treatment, does not influence prognosis.