Godik O. Reoperations in the treatment of portal hypertension on children

The results of surgical treatment for 283 children were studied. Out of all the operated children a group with unsatisfactory results was underlined, which made up 74 (26.1%) patients. Depending on the primary operation all the patients were divided into groups: children after azygoportal disconnection (n-47 (63.5%)), children after shunting procedures (n=27 (36.5%)). Based on the results of a complex study of the patients the informativety of each diagnostic method was determined (ultrasound of the abdominal cavity, esophgogastroscopy, multispiral computed tomography) to evaluate the reasons for unsatisfactory results of the primary operation. An algorithm was proposed for choosing the type of surgical treatment in children with portal hypertension depending on the age and the characteristics of the pathology- on the special preoperative care, choosing the type of surgical treatment and prophylaxis of postoperative complications, that ensures better outcome of the surgical treatment. The effectiveness of shunting was determined, which came to be 87.8% and only 12.2% is the palliative operations. Based on studying the portohepatic perfusion depending on the type of the shunt, an optimal approach was determined in choosing the type of surgical treatment for primary operative care and also for reoperations in children with recurrent varicel bleeding . The proposed variants for reoperations gave the ability to decrease the frequency of complications to 9.4% relatively to 26.6% of complications after primary surgical treatment. Field - medicine.