CRITICAL APPRAISAL OF SURGICAL THESES ON PORTAL HYPERTENSION.

Background: There are few local guidelines on the management of patients with oesophageal varices secondary to 
schistosomal hepatic fibrosis. The study aims at exploring this issue through a critical appraisal of the methodology used in surgical theses on portal hypertension. 
Material and methods: All surgical theses on portal hypertension, written over a 27-year period were analyzed through 
established criteria for evaluating research on portal hypertension. 
Results: Study design analysis revealed that 90% theses were case series reports and 10% were randomized clinical 
trials. Control of bleeding and patient survival were primary research end points in 30% and 25% of the theses, respectively. 
None of the theses had the number of patients required for their study statistically calculated beforehand. Patient population was defined in 30% of the theses and was heterogeneous in 50% of the theses; mixing bleeders with non-bleeders. Child-Pugh grading was followed in 15% of the theses. Endoscopic variceal grading was performed in 55% of the theses and in 10% were endoscopic risk signs for bleeding reported. 
Conclusion: This study has demonstrated the need for well-designed clinical trials on portal hypertension that have end 
points of primary importance, such as patient survival and control of bleeding.