Modified sugiura procedure: an alternative for non-cirrhotic patients with extrahepatic portal vein thrombosis and recurrent variceal bleeding

Authors

DOI:

https://doi.org/10.22516/25007440.383

Keywords:

Thrombosis, Portal vein, Extrahepatic, Portal hypertension, Modified Sugiura, Esophageal varices, Cirrhosis

Abstract

One of the most serious consequences of extrahepatic portal vein thrombosis is portal hypertension with recurrent variceal bleeding. Once endoscopic variceal ligation fails and the spleno-portal axis is not permeable, modified Sugiura devascularization may be the only alternative. Its use in patients with cirrhosis has been reported, but there is little information on non-cirrhotic patients. This article presents a series of four cases of non-cirrhotic patients that underwent this procedure. Patients were followed for twelve months; none presented episodes of esophageal varices re-bleeding nor required ligation of residual varices. This surgery is outlined as a therapeutic alternative for this type of patients.

Downloads

Download data is not yet available.

Author Biographies

Juan Manuel Rico Juri, Centro Medico Imbanaco

Cirujano hepatobiliar y de trasplantes. Centro Medico Imbanaco

Felipe Castro Villegas, Centro Medico Imbanaco

Cirujano  Hepatobiliar, Centro Medico Imbanaco

Carmen Elisa Ocampo Benavides, Centro Medico Imbanaco

Medica Epidemiologa. Instituto de Investigaciones, Centro Medico Imbanaco

References

Sugiura M, Futagawa S. A new technique for treating esophageal varices. J Thorac Cardiovasc Surg. 1973;66(5):677-685.

https://doi.org/10.1016/S0022-5223(19)40560-6

Sugiura M, Futagawa S. Esophageal transection with paraesophagogastric devascularizations (the Sugiura procedure) in the treatment of esophageal varices. World J Surg. 1984;8(5):673-679.

http://doi.org/10.1007/BF01655762

Voros D, Polydorou A, Polymeneas G, Vassiliou I, Melemeni A, Chondrogiannis K, Arapoglou V, Fragulidis GP. Long-term results with the modified Sugiura procedure for the management of variceal bleeding: standing the test of time in the treatment of bleeding esophageal varices. World J Surg. 2012;36(3):659-66.

http://doi.org/10.1007/s00268-011-1418-7

Schettini AV, Pinheiro RS, Pescatore P, Lerut J. Modified Sugiura Operation for Idiopathic Portal Hypertension with Bleeding Oesophageal Varices. A Case Report. Acta Chir Belg. 2015;115(3):237-240.

http://doi.org/10.1080/00015458.2015.11681105

Garcia-Pagán JC, Hernández-Guerra M, Bosch J. Extrahepatic portal vein thrombosis. Semin Liver Dis. 2008;28(3):282-292.

http://doi.org/10.1055/s-0028-1085096

Valla DC, Condat B. Portal vein thrombosis in adults: pathophysiology, pathogenesis and management. J Hepatol. 2000;32(5):865-871.

http://doi.org/10.1016/s0168-8278(00)80259-7

Llop E, Seijo S. Treatment of non-cirrhotic, non-tumoural portal vein thrombosis. Gastroenterol Hepatol. 2016;39(6):403-410.

http://doi.org/10.1016/j.gastrohep.2015.09.007

Yerdel MA, Gunson B, Mirza D, Karayalçin K, Olliff S, Buckels J, Mayer D, McMaster P, Pirenne J. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome. Transplantation. 2000;69(9):1873-81.

http://doi.org/10.1097/00007890-200005150-00023

Grace ND. Prevention of initial variceal hemorrhage. Gastroenterol Clin North Am. 1992;21(1):149-161.

de Franchis R, Primignani M. Endoscopic treatments for portal hypertension. Semin Liver Dis. 1999;19(4):439-455.

http://doi.org/10.1055/s-2007-1007131

Soonawalla ZF, Shah SR, Mathur SK. Modified sugiura procedure. 2002;194(2):247.

https://doi.org/10.1016/S1072-7515(01)01146-2

Dagenais M, Langer B, Taylor BR, Greig PD. Experience with radical esophagogastric devascularization procedures (Sugiura) for variceal bleeding outside Japan. World J Surg. 1994;18(2):222-8.

http://doi.org/10.1007/BF00294405

Mercado MA, Orozco H, Vasquez M, Pantoja JP, Contreras A, Catzin-Kuhlmann A, Flores A, Rodriguez-Davalos M. Comparative study of 2 variants of a modified esophageal transection in the Sugiura-Futagawa operation. Arch Surg. 1998;133(10):1046-9.

http://doi.org/10.1001/archsurg.133.10.1046

Figura 1. Técnica de Sugiura original frente a la técnica modificada

Downloads

Published

2020-09-30

How to Cite

Rico Juri, J. M., Castro Villegas, F., & Ocampo Benavides, C. E. (2020). Modified sugiura procedure: an alternative for non-cirrhotic patients with extrahepatic portal vein thrombosis and recurrent variceal bleeding. Revista Colombiana De Gastroenterología, 35(3), 377–381. https://doi.org/10.22516/25007440.383

Issue

Vol. 35 No. 3 (2020): Julio - Septiembre

Section

Case report

License

Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:

Los autores/as ceden sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación en esta revista.

Los contenidos están protegidos bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.

Licencia de Creative Commons

Altmetric

Crossref Cited-by logo
Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code

Some similar items: