Portal venous pressure in non-cirrhotic bilharzial patients undergoing elective splenectomy, can it affect mortality? A prospective study

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Tourky M.; Youssef A.; Salman M.; Abouelregal T.; Tag El-Din M.; Moustafa A.; Taha A.; El-Mikkawy A.; Saadawy A.; Salman A.

Journal: Acta Gastro-Enterologica Belgica

Publisher: Universa Press

Publication Date: November 2021

Volume / Issue: Volume 84 / Issue 4

Pages: 549–556

ISSN: 17843227

DOI: 10.51821/84.4.004

Scopus: View on Scopus

PubMed: 34965035

Document Type: Article

Access: All Open Access; Bronze Open Access

Authors and Affiliations

Tourky M., Department of Surgery, Great Western Hospitals NHS Foundation Trust, Swindon, United Kingdom; Youssef A., Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt; Salman M., General Surgery Department, Faculty of Medicine, Cairo University, Egypt; Abouelregal T., Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt; Tag El-Din M., General Surgery Department, Faculty of Medicine, Al-Azhar university, Cairo, Egypt; Moustafa A., Department of Endemic Medicine and Hepatology, Faculty of medicine, Cairo University, Egypt; Taha A., Department of Endemic Medicine and Hepatology, Faculty of medicine, Cairo University, Egypt; El-Mikkawy A., Theodor Bilharz Research Institute, Hepatology and Gastroenterology Department, Cairo, Egypt; Saadawy A., Radiology Department, Faculty of medicine, Ain Shams University, Cairo, Egypt; Salman A., Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt

Abstract

Background and study aims: To evaluate the impact of intra-operatively measured portal vein pressure (PVP) on mortality in non-cirrhotic bilharzial patients undergoing splenectomy. Methods: The present study is a prospective study that was conducted in Egypt from April 2014 to April 2018. Adult patients with non-cirrhotic bilharziasis who were scheduled to undergo splenectomy were included. Studied cases were divided into a survival cohort and a non-survival cohort. The main objective was the correlation between the incidence of mortality and intraoperative PVP. Results: The present work comprised 130 cases with a mean age of 51.8 ± 6.4 years old. The in-hospital mortality rate was 22.3%, with sepsis as a major cause of death (37.9%). In term of the association between preoperative variables and mortality, survivors had statistically significant lower portal vein diameter (13.6 ± 1.8 versus 15.2 ± 1.8mm; p<0.001) and higher portal vein velocity (14.2 ± 1.8 versus 10.4 ± 2.3 cm/sec; p<0.001) than non-survivors. The survived patients had significantly lower PVP (13.9 ± 1.1 versus 17.7 ± 2.7; p <0.001). A cut-off value of ≥14.5 mmHg, the PVP yielded a sensitivity of 86.2% and a specificity of 69% for the prediction of mortality. The association analysis showed a statistically significant association between mortality and postoperative liver function parameters. Conclusions: High intraoperative PVP is linked to early postoperative death in non-cirrhotic cases undergoing splenectomy. Our study showed that PVP > 14.5mmHg was an independent predictor of death and showed good diagnostic performance for the detection of early postoperative mortality. (Acta gastroenterol. belg., 2021, 84, 549-556). © 2021, Universa Press. All rights reserved.

Keywords

Bilharziasis; Portal venous pressure; Postoperative mortality; Splenectomy; adult; Article; cause of death; cohort analysis; controlled study; diagnostic procedure; Doppler flowmetry; Egypt; female; human; in-hospital mortality; incidence; intraoperative period; liver function; liver schistosomiasis; major clinical study; male; middle aged; mortality rate; portal vein blood pressure; prediction; preoperative period; prospective study; risk factor; schistosomiasis; sensitivity and specificity; sepsis; survival rate; survivor; treatment outcome; vein diameter

Citation Information

Scopus Citations: 0

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