Evaluation of Quality of Life in Patients with Liver Cirrhosis with Portal Hypertension after Portosystemic Shunt
¹V. Vakhidov Republican Specialized Center of Surgery, Tashkent, Uzbekistan ²Bukhara State Medical Institute, Bukhara, Uzbekistan
*Corresponding author: Azam H. Babajanov, PhD, Senior Researcher, Department of Portal Hypertension and Pancreatoduodenal Surgery, V. Vakhidov Republican Specialized Center of Surgery. 22, General Petrov str., apt. 2, 100000, Tashkent, Uzbekistan. Tel: 998-71-2770617 (office), E-Mail:firstname.lastname@example.org
The quality of life in was analyzed in 248 patients with liver cirrhosis with portal hypertension after portosystemic shunting. All patients underwent decompressive surgery options, in 135 cases - a selective distal splenorenal anastomosis, in 113 cases - different versions of the central decompression. In the study used a questionnaire developed by Younossi ZM et al. (1999) for patients with chronic liver diseases - The Chronic Liver Disease Questionnaire (CLDQ). It is proved that PSS not only does not degrade the quality of life indicator in patients with risk of hemorrhage from esophageal and gastric varices, but also slightly improves the value. In the remote period after the shunting, progressive pathological process in the liver contributes to the development of functional disability of hepatocytes, that in terms of adequate decompression is the main cause of a fatal outcome. This trend was obtained for all parameters of the analysis of the quality of life indicator, with a gradual deterioration of values with increasing of observation period length. Depending on the type of decompression, noted the following features. In patients with the central anastomoses, the range of liver complications was dominated (liver failure, encephalopathy). On the background of selective decompression, in which in the short term is possible to maintain a high residual portal pressure, noted the prevalence of edematous-ascitic syndrome and the development of a hemorrhagic syndrome, even in the functional capable shunt. At the same time, to 6-12 months after the distal anastomosis, hemodynamic reorganization in the portal system generally leads to an increase in the degree of decompression, leveling the rate of specific complications for this type of shunting.
- Bell CL, Jeyarajah DR. Management of the cirrhotic patient that needs surgery. Curr Treat Options Gastroenterol 2005; 8(6):473-80.
- Gregory Fitz J. Feldman: Sleisenger & Fordtran’s Gastrointestinal and Liver Disease, 7th ed. 2002; 1543–9.
- Jain A, Reyes J, Kashyap R, et al. Long-term survival after liver transplantation in 4000 consecutive patients at a single center. Ann Surg 2000; 232(4):490-500.
- Klupp J, Kohler S, Pascher A, Neuhaus P. Liver transplantation as ultimate tool to treat portal hypertension. Dig Dis 2005; 23(1):65-71.
- Rubio Gonzalez EE, Moreno Planas JM, Jimenez Garrido MC, et al. Results of liver transplantation in patients with previous portosystemic shunts. Transplant Proc 2005; 37(3):1491-2.
- Sozen H, Karakayali H, Moray G, et al. Analysis of postsurgical complications in 75 living liver transplantation donors. J Gastrointest Surg 2006; 10(5):646-51.
- Sundaram V, Shaikh Obaid S. Hepatic encephalopathy: pathophysiology and emerging therapies. The Medical Clinics of North America. 2009l; 93 (issue 4):819-36.
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Int J Biomed. 2012; 2(2):124-127. © 2012 International Medical Research and Development Corporation. All rights reserved.