J.Jpn. Surg. Soc.. 87(2): 206-210, 1986
Original article
AN ANALYSIS OF PROGNOSTIC EXAMINATION IN CIRRHOTIC PORTAL HYPERTENSION AND HEPATOMA
|
Department of Surgery, Aichi Medical University, Aichi, Japan Kotohito Takeshige, Sadahiro Yamamoto, Hirohiko Kojima, Toshiyuki Arakawa, Hirofumi Kuroda, Yoji Kawai, Yoshitaka Fukaya |
To correct this discrepancy, additional prognostic examinations to Child’s criteria and routine hepatic laboratory tests were studied in our 246 cirrhotic patients with esophageal varices. These included 1) wedged hepatic vein pressure, 2) clearance and 3) maximal removal rate of indocyanine green, and 4) hepaplastin test.
We performed the endoscope assisted terminal esophagoproximal gastrectomy with the EEA stapler gun with devascularization and splenectomy. No operative death and complications developed when the results of following 4 preoperative examinations were：1) wedged hepatic vein pressure below 400mm of saline, 2) peripheral disappearance rate (K) of indocyanine green above 0.04min－1, 3) maximal removal rate (Rmax) of the dye above 0.3mg/kg/min and 4) hepaplastin test more than 40％. It is necessary for these indicators to be satisfied simultaneously prior to performing this surgery.
In addition, these values should be changed a little in their critical limits when these cirrhotic patients also had hepatoma and were candidated for hepatectomy.
To read the PDF file you will need Adobe Reader installed on your computer.