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Hassab's operation for Cirrhotic Patients/Varices
Recent role of Hassab's operation for cirrhotic patients: Combination with endoscopic procedure for varices.

Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Abstract

Recently, endoscopic and radiological procedures for various symptoms related to cirrhosis have improved. Thus, the role of Hassab's operation (gastroesophageal decongestion and splenectomy) has changed for cirrhotic patients.
METHODS:

Hassab's operation was performed on patients who had gastroesophageal varices that were difficult to control with balloon occluded retrograde transvenous obliteration or an endoscopic procedure, or had hypersplenism. Thirteen consecutive patients underwent this operation, and the outcomes of all patients were reviewed retrospectively.
RESULTS:

There was no operative morbidity or rebleeding varices. In the preoperative endoscopic injection sclerotherapy treated group (n=6), only one patient (16.7%) developed recurrent varices. Mean platelet counts were significantly higher 6 months after surgery (201±65×10(3)/mm(3)) than preoperatively (64±54×10(3)/mm(3)). In patients with hepatocellular carcinoma, percutaneous therapies, such as radio frequency ablation, were safely performed with adequate therapeutic effect. Interferon therapy was given to patients with hepatitis C virus (HCV)-related cirrhosis without interruption.
CONCLUSION:

Hassab's operation is a satisfactory approach to controlling varices, especially when combined with preoperative endoscopic treatment. Platelet counts were significantly higher after surgery. This therapy was important for cirrhotic patients contraindicated for liver transplantation in that they could continue their therapy for hepatocellular carcinoma (HCC) and HCV as needed.

See:   http://www.ncbi.nlm.nih.gov/pubmed/22720859

Mike
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Thanks for the good information Mike. Good to know they are working on improving procedures for patients with variceal bleeds. Hopefully they will expand the study to a larger group of patients to confirm the data.

Cheers!

Hector
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Great post Mike, as always it is nice to read your helpful and informative posts! Welcome to our new cirrhosis of the liver community.

Randy
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