Management strategy for gastric cancer with liver cirrhotic portal hypertension

/Pan Ming

(潘明，Dept Gen Surg，Peop Hosp Shanghai Jiaotong Univ，Shanghai 200020)…∥Chin JGen Surg.-2011，14(8).-674～676

ObjectiveTo assess the concurrent management for portal hypertension(PHT)in gastric cancer patients.MethodsRetrospective analysis was made on 60 cases of gastric cancer occurring on the background of cirrhotic PHT，of which 30 cases were of Child A grade，and 30 patients were Child B class.Ten cases were on gastric cancer stageⅠ，38 cases on stageⅡ and 12 cases were on stageⅢ.Radical gastrectomy plus splenectomy and devascularization were performed in 26 cases，while radical gastrectomy only was done in 34 cases.ResultsPostoperative Child-Pugh degrading developed in 100%cases undergoing combined procedures;while in the 34 cases undergoing radical gastrectomy only，postoperative degradation from the preoperative Child-Pugh classification occurred in 7 cases(20%)，P ＜0.001.In this series the peri-operative mortality was 3%，all were patients at stageⅢgastric cancer combined with Child-Pugh class B.ConclusionThe principle of treatment for gastric cancer with cirrhotic portal hypertension is restrictive surgery.The main purpose is to cure cancer and not to damage liver function.8 refs，3 tabs.