Hassab's Operation Research Articles

The development of extrahepatic portal obstruction after undergoing multiple operations for a congenital dilatation of the bile duct: Report of a case

As a long-term complication after undergoing a cystenterostomy for a congenital dilatation of the bile duct, liver cirrhosis due to stenosis of the anastomosis or reflux cholangitis has been reported in conjunction with subsequent portal hypertension. We treated a 48-year-old Japanese woman who developed both portal hypertension and pancytopenia after undergoing multiple operations for a congenital dilatation of the bile duct. She underwent a Hassab's operation in July 1994, when an occlusion of the extrahepatic portal vein, which resulted in portal hypertension, was first noted; the liver was microscopically normal. The etiology of the extrahepatic portal obstruction in our patient was most likely due to either repeated inflammation or adhesion at the hepatic hilus. Based on these findings, the differential diagnosis of portal hypertension after an operation for a congenital dilatation of the bile duct should therefore include an extrahepatic portal obstruction in addition to liver cirrhosis.

Concept on Prophylactic Hassab's Operation to Solitary Gastric Varices

Concept on Prophylactic Hassab's Operation to Solitary Gastric Varices

The evaluation of Hassab's operation for residual and recurrent gastroesophageal varices after endoscopic treatment

The evaluation of Hassab's operation for residual and recurrent gastroesophageal varices after endoscopic treatment

A CASE OF FELTY'S SYNDROME WITH PORTAL HYPERTENSION

A 51-year-old woman was admitted to another hospital because of repeated hematemesis which started on September 21, 1994, and was diagnosed as having Felty's syndrome. The patient had been suffering from rheumatoid arthritis for about 10 years and had been pointed out a splenomegaly and esophageal varices 3 years before. The patient was admitted to the hospital for close examination and treatment on January 4, 1995. Physical examination on admission revealed pigmentation in the skin of bilateral legs. Decreases in white blood cells and plateletes counts, positive response to antinuclear antibody, and an increased level of rheumatoid factor were noted. Abdominal CT visualized remarkable splenomegaly. On catheter examination via the hepatic vein, there were some findings suggestive of idiopathic portal hypertension (IPH). For the esophageal varices, endoscopic sclerotherapy was conducted the three times, and thereafter a Hassab operation and hepatic biopsy were performed on March 8. Histopathologic findings of the liver were compatible with IPH. Upper gastrointestinal endoscopic study conducted on the first month after the operation confirmed disappearance of the esophageal varices, and the white blood cells and platelets counts were normalized.

The results and problems of the combined therapy of Hassab operation with endoscopic injection sclerotherapy to esophago-gastric varices

The results and problems of the combined therapy of Hassab operation with endoscopic injection sclerotherapy to esophago-gastric varices

Renal Function and Morphology in Sudanese Patients with Advanced Hepatosplenic Schistosomiasis and Portal Hypertension

The association between glomerular disease and hepatosplenic schistosomiasis is well documented in reports from South America. During the present hospital investigation in Sudan, 58 patients admitted for intercurrent complications of advanced hepatosplenic schistosomiasis were studied. The patients, median age 35 years, had no concurrent Schistosoma haematobium infection. Diagnostic criteria included an enlarged spleen (n = 58), at least 1 episode of hematemesis (n = 55) and/or melena (n = 36), endoscopical demonstration of gastroesophageal varices (29/29 studied), ultrasonographical imaging of hepatic periportal fibrosis (18/18 studied), and intraoperative liver biopsy with characteristic histological findings (11/16 biopsied). Serum creatinine, urea, electrolytes, cholesterol, total protein, and electrophoresis were within normal limits. Median urinary protein/creatinine ratio was 0.06 and thereby not significantly different from European reference values. Only 1 patient had proteinuria of 1.7 g/l. Minimal hematuria was found in 5 patients. Ten kidney biopsies were taken intraoperatively during a portal decompression procedure (Hassab operation). Light, immunofluorescence, and electron microscopy produced no evidence of glomerulonephritis. These findings indicate that S. mansoni induced nephrotic syndrome may be less frequent in Sudan than in South America. Renal involvement due to S. mansoni infection may therefore encompass geographical variances.