Surgical outcome of extrahepatic portal venous obstruction: Audit from a tertiary referral centre in Eastern India

• DOI: 10.14701/ahbps.23-025
• Publication Date: 2023-06-20T01:51:01Z
• Authors: Somak Das; Tuhin Subhra Manadal; Suman Das; Jayanta Biswas; Arunesh Gupta; Sreecheta Mukherjee; Sukanta Ray
• Keywords: Portal vein thrombosis

Backgrounds/Aims: Extra hepatic portal venous obstruction (EHPVO) is the most common cause of hypertension in Indian children.While endoscopy primary modality management, a subset patients require surgery.This study aims to report short-and long-term outcomes EHPVO managed surgically.Methods: All with who underwent surgery between August 2007 and December 2021 were retrospectively reviewed.Postoperative complications classified after Clavien-Dindo.Binary logistic regression Wald methodology was used determine predictive factors responsible for unfavourable outcome.Results: Total 202 operated.Mean age 20.30 ± 9.96 years, duration illness, 90.05 75.13 months.Most indication biliopathy (n = 59, 29.2%), followed by bleeding 50, 24.8%).Total 166 (82.2%) had shunt procedure.Splenectomy esophagogastric devascularization second 20, 9.9%).Nine major postoperative (Clavien-Dindo > 3) observed 8 (4.0%), including 1 (0.5%) operative death.After median follow-up 56 months (15-156 months), favourable outcome.In multivariate analysis, associated splenic artery aneurysm (p 0.007), isolated gastric varices 0.004), preoperative endoscopic retrograde cholangiography stenting 0.015), occlusion < 0.001) independent predictors outcome.Conclusions: Surgery safe, affords excellent outcome symptomatic EHPVO, may be considered secondary prophylaxis.