Value of measuring variceal pressure before and after splenectomy and gastro-oesphageal devascularisation in Bilharzial hepatic fibrosis

ABSTRACT

This study was conducted on 38 patients with schistosomal hepatic fibrosis, splenomegally, and history of bleeding esophageal varices. An elective splenectomy and gastroesophageal devascularisation was done for all patients. Liver function tests and endoscopic variceal pressure measurements by pneumatic gauge were done for each patient pre-operatively and 6 months postoperatively. There were significant improvement of liver functions and significant drop of variceal pressure after the operation. Recurrent bleeding occurred in 4 patients [about 10%] who did not show drop of their variceal pressure. Splenectomy and gastroesophageal devascularisation is an effective operation in reducing the variceal pressure and improving the liver functions. Recurrent bleeding could be prevented by prophylachic sclerotherapy for patients in whom the variceal pressure does not drop after surgery