Secretariat: The Second Department of Surgery, University of Tokyo, Tokyo, Japan.
Improved survival after prophylactic portal nondecompression surgery for esophageal varices: A randomized clinical trial
Article first published online: 5 DEC 2005
Copyright © 1990 American Association for the Study of Liver Diseases
Volume 12, Issue 1, pages 1–6, July 1990
How to Cite
Inokuchi, K. (1990), Improved survival after prophylactic portal nondecompression surgery for esophageal varices: A randomized clinical trial. Hepatology, 12: 1–6. doi: 10.1002/hep.1840120102
- Issue published online: 5 DEC 2005
- Article first published online: 5 DEC 2005
- Manuscript Accepted: 20 OCT 1989
- Manuscript Received: 5 JUL 1988
- grant-in-aid for cooperative research of the Ministry of Education, Science and Culture. Grant Number: 00537021
To evaluate prophylactic surgery for esophageal varices, a prospective randomized controlled trial was begun in 1980 by the Japanese Research Society for Portal Hypertension. Methods of operation included selective shunts and nonshunting interruption procedures. One hundred and twelve Japanese patients, in whom endoscopic findings suggested risk of bleeding but who had no bleeding episode, were randomly allocated to the operated group of 60 patients or nonoperated group of 52 patients. Nine patients with idiopathic portal hypertension, histologically proven noncirrhotic disease, which all fell in the operated group, were excluded from the study and the remaining 103 patients (51 operated and 52 nonoperated) were analyzed. Long-term follow-up of patients for a median of 49 mo with a maximum of 73 mo showed a total of 11 (22%) deaths, including 2 operative deaths, in the operated group compared with 23 (49%) deaths in the nonoperated group. The cumulative survival rate at 5 yr in the operated group was 72%, which was significantly higher than the 45% of the nonoperated group (p < 0.05). The cumulative variceal bleeding rate at 5 yr was 7% in the operated group, which was significantly lower than that of the nonoperated group of 46% (p < 0.001). It was concluded that portal nondecompression surgery was effective in preventing the variceal bleeding and in improving survival. (HEPATOLOGY 1990; 12:1–6).