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Article
October 1997

Surgery in Elderly Patients in MexicoPortal Hypertension Surgery as an Example

Author Affiliations

From the Surgical Division, Instituto Nacional de la Nutrición, Mexico City, Mexico.

Arch Surg. 1997;132(10):1126-1128. doi:10.1001/archsurg.1997.01430340080014
Abstract

Although people older than 65 years represent less than 5% of Mexico's registered population, medical care for elderly patients requires a multidisciplinary approach. In our academic university hospital, they are managed by a team of specialists. As an example of this approach, we evaluated the surgical treatment of bleeding portal hypertension in a highly selected elderly population. A retrospective study was done reviewing the files of 25 patients older than 65 years. All had good liver function (Child-Pugh class A and B) and had undergone elective surgery. Sixteen of them were women. The mean age was 68.8 years (age range, 65-76 years), and most had a diagnosis of cirrhosis. All patients were treated with portal blood flow—preserving procedures (selective shunts or Sugiura-Futagawa procedures). The operative mortality was 8%. Eight later deaths were recorded, with a mean follow-up of 25 months (range, 2-110 months). Survival (Kaplan-Meier) was 87% at 12 months, 54% at 60 months, and 45% at 110 months. Two rebleeding incidents were recorded as well as 3 cases of postoperative encephalopathy. We concluded that well-selected elderly patients, undergoing elective surgery with portal blood flow—preserving procedures, have a good postoperative outcome.

Arch Surg. 1997;132:1126-1128

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