par Burette, Alain;De Reuck, Marc 
;Van Gossum, Marc ;Dumont, Nathalie ;Jonas, Claude ;Deltenre, Michel Arthur
Référence Acta endoscopica, 15, 2, page (131-138)
Publication Publié, 1985-04
;Van Gossum, Marc ;Dumont, Nathalie ;Jonas, Claude ;Deltenre, Michel Arthur Référence Acta endoscopica, 15, 2, page (131-138)
Publication Publié, 1985-04
Article révisé par les pairs
| Résumé : | The relationship between laparoscopic and upper G. I. features of portal hypertension (P. H. T.) has been studied in 269 cirrhotic patients. No features of P.H. T. was observed in 31 %. Intraabdominal collateralization was present in 153 (57 %) and esophageal varices in 145 (53 %). There is a significant correlation between the presence of intra- abdominal collateral vessels and the presence of varices (p < 0,0005). However 12 % of cirrhotic patients without intra- abdominal collateralization presented esophageal varices, bleeding in 113 cases. Likewise a similar significant correlation was found between the presence of ascites and the presence of varices (p < 0,0005). But neither the presence of ascites nor the presence of intra- abdominal collateralization allow to anticipate the size of the esophageal varices. According to the presence or absence of P.H. T. features (at laparoscopy and/or upper G.I. endoscopy) 44 % and 31 % of patients presented associated upper G. I. lesions, mainly erosive and exulcerative ones. These were significantly more frequent when P. H. T. features were present (p < 0,0025). Portohepatic gradient, assessed by corrected sinusoidal pressure was significantly higher in patients with intra- abdominal collateral vessels (p < 0,02) or with ascites (p < 0,01). Whatever the value of laparoscopy in assessing the portal collateral circulation, the usefulness of upper G.I. endoscopy in cirrhotic patients must be emphasized for searching and grading esophageal varices and screening for associated lesions. © 1985 Springer-Verlag. |
