Results of a Modified Distal Spleno-renal Shunt for Portal Hypertension
- 1 February 1977
- journal article
- research article
- Published by Wolters Kluwer Health in Annals of Surgery
- Vol. 185 (2), 224-228
- https://doi.org/10.1097/00000658-197702000-00016
Abstract
Twenty-five patients were treated with a distal spleno-renal shunt modified after that of Warren. The operative mortality was 4/25. One patient had an early thrombosis. All post-operative angiography otherwise showed patent shunts. After a median observation time of 43 months, 10/20 patients included in the followup were dead. The chief cause of death was liver failure. Encephalopathy has been common although generally of minor degree Hypersplenism, judged by thrombocyte count, was not significantly affected by the operation. Six of 21 patients have had gastrointestinal hemorrhage after the operation but no hemorrhage proved fatal. Postoperatively esophageal varices size was considerably diminished in most cases as judged by contrast x-ray. Ascites has not been a problem in this series. Postoperative angiography showed a marked and rapid reduction of portal blood flow to the liver with progressively more blood deviated through the coronary vein towards the shunt. This reduction in portal flow is a possible explanation of the high frequency of postoperative liver failure. This version of the distal spleno-renal shunt has probably no advantages over the portacaval shunt.This publication has 18 references indexed in Scilit:
- A Series of 20 Successful Warren ShuntsArchives of Surgery, 1975
- A Controlled Study of the Therapeutic Portacaval ShuntGastroenterology, 1974
- [Distal splenorenal anastomosis in the treatment of portal hypertension in the cirrhotic patient (author's transl)].1974
- [Elective decompression of esophago-gastric varices using distal spleno-renal anastomosis].1974
- Selective Distal Splenorenal ShuntArchives of Surgery, 1974
- Therapeutic Portacaval ShuntArchives of Surgery, 1974
- Evaluation of selective transsplenic decompression of gastroesophageal varicesThe American Journal of Surgery, 1974
- PROPHYLACTIC PORTACAVAL ANASTOMOSISMedicine, 1972
- One Thousand Cases of Portal Cirrhosis Of the LiverArchives of Internal Medicine, 1964
- The natural history of the patient with cirrhosis of the liver with esophageal varices following the first massive hemorrhage.1958