Long-term results of portal hypertension surgical correction and survival risk factors for patients with liver cirrhosis

The treatment results of 144 patients with portal hypertension syndrome caused by liver cirrhoses are presented. According to the Child - Pugh scale the patients were divided into the following groups: group A was 43 (29,9%), group B - 81 (56,3%), and group C - 20 (13,9%). Distal splenorenal shunting was performed in 68 (49,3%) patients, various partial shunts were made in 71 (49,3%), TIPS - in 5 (3,5%) patients. There was distinct regress of the oesophagus varicose extension level in the long-term period after portal system operative decompression. There were no cases of vascular anastomosis thromboses or esophageal re-bleeding in the long-term follow-up. One-year cumulative survival after portocaval shunt was 84,8±3,1%, and three-, five-, and ten-year surviving were 68,6±4,2%, 51,3±4,9% and 25,8± 5,4% respectively. Patients' life expectancy was defined by basic level of liver dysfunction and did not depend on sex, age, cirrhoses etiological factor and on the type of portocaval anastomosis. The survival leading risk factors were: diureticresistant ascites, common bilirubin more than 43 mcmole/l, albumine less than 30 g/l, creatinine more than 78 mcmole/l, volume flow of the portal vein less than 600 ml\min, plasma disappearance rate of indocian green less than 8%/min and histological activity index more than 9. The planning of selective and partial portocaval shunting due to the detected prognosis criteria will assist the improvement of surgical treatment results in patients with liver cirrhoses.