Evaluation of Quality of Life in Patients with Liver Cirrhosis with Portal Hypertension after Portosystemic Shunt

The quality of life in was analyzed in 248 patients with liver cirrhosis with portal hypertension after portosystemic shunting. All patients underwent decompressive surgery options, in 135 cases - a selective distal splenorenal anastomosis, in 113 cases - different versions of the central decompression. In the study used a questionnaire developed by Younossi ZM et al. (1999) for patients with chronic liver diseases - The Chronic Liver Disease Questionnaire (CLDQ). It is proved that PSS not only does not degrade the quality of life indicator in patients with risk of hemorrhage from esophageal and gastric varices, but also slightly improves the value. In the remote period after the shunting, progressive pathological process in the liver contributes to the development of functional disability of hepatocytes, that in terms of adequate decompression is the main cause of a fatal outcome. This trend was obtained for all parameters of the analysis of the quality of life indicator, with a gradual deterioration of values with increasing of observation period length. Depending on the type of decompression, noted the following features. In patients with the central anastomoses, the range of liver complications was dominated (liver failure, encephalopathy). On the background of selective decompression, in which in the short term is possible to maintain a high residual portal pressure, noted the prevalence of edematous-ascitic syndrome and the development of a hemorrhagic syndrome, even in the functional capable shunt. At the same time, to 6-12 months after the distal anastomosis, hemodynamic reorganization in the portal system generally leads to an increase in the degree of decompression, leveling the rate of specific complications for this type of shunting.