Abstract:
Introduction: Liver cirrhosis is one of the great problems of gastroenterological pathology,
as well as a public health problem because of the high incidence, chronicity, severity of
complications and high costs involved in the care of these patients. Approximately 77% of patients
with hepatic cirrhosis have a severe hipersplenic syndrome with forecast reserved. Surgical
approach has proven to be very effective in solving the severe hipersplenic syndrome.
Purpose and objectives: To analyze the clinical and laboratory characteristics in patients
with cirrhosis of different etiology within 6 months to 3 years after surgery by azygo-portal
devascularisation and splenectomy.
Materials and methods: We studied retrospective 47 patients with liver cirrhosis
hospitalized in the department of hepatology and hepato-biliary surgery departments of IMSP -
SCR, from 2010 to 2013, undergoing surgical treatment of solving the portal-hypertensive
splenopathy. The diagnosis was confirmed clinically, biologically and imagistically. Clinical and
laboratory results were analyzed using patient’s clinical observation sheets from the archive of
IMSP-Republican Hospital using Microsoft Office Excel 2007 and SPSS v. 17.0 programs.
Results: It has been found:
> a significant improvement of the asthenic, hemorrhagic, abdominal pain and dyspeptic
syndromes;
> a statistically significant improvement for platelets, leukocytes, erythrocytes and an
improvement of the hepatocellular insufficiency syndrome characterized by prothrombin and
fibrinogen;
> many of the patients who gather the score for Child-Pugh class B before the surgery passed
in class A after it, which shows an improvement in the clinical and paraclinical features;
> a significant decrease in the incidence of upper gastrointestinal bleeding (50% before and
10% after) and its severity after surgery.
Conclusions: This study showed the benefits of surgery by azygo-portal devascularisation
and splenectomy in improving the clinical and paraclinical manifestations in patients with liver
cirrhosis with portal hypertension.
