Studies on the Results of the Nonshunting　Procedures for Portal Hypertension

The number of operations for portal hypertension performed, in our institute, during the period of 1973 through 1981 was 68. The nonshunting procedure used on all of them was the Tokyo-University-Second-Surgery method (Sugiura's method). The results of these operations have been studied and presented in this paper.

It was noted that the mortality was 7.7% by Sugiura's method, as compared to 13.3% by transthoracic esophageal transection (esophageal transection), and 18.5% by Hassab's method. According to Child's classification, Child A was 0%, B, 9.8% and C, 35.7%.

The accumulated survival rate proved good after Sugiura's method, as classified by the formula, in idiopathic portal hypertension (IPH), as classified by the basic disease, in prophylactic operation, as classified by the time of surgery, and in Child A, according to Child's classification, respectively. Esophageal varices examined with an endoscope disappeared for the most part after Sugiura's method, indicating good improvement. After Sugiura's method, no recurrence of bleeding was observed, whereas after esophageal transection, one case of bleeding (6.7 %) and one case (3.7 %) after Hassab's operation were noted.

The results suggest that Sugiura's method is associated with the best results when the mortality, accumulated survival rate, endoscopic findings, and the recurrence rate of bleeding are considered.