Distal splenocaval shunt for rebleeding patients after periesophagastric devascularization

VernacularTitle:选择性远端脾腔静脉分流术治疗门静脉高压症患者断流术后再出血
Author: Guangwen ZHOU
Publication Type:Journal Article
Keywords: Hypertension,portal; Esophegeal and gastric varices; Portacaval shunt,surgical; Postoperative hemorrhage
From: Chinese Journal of General Surgery 2013;(4):263-265
CountryChina
Language:Chinese
Abstract: Objective To evaluate the therapeutic effect of distal splenocaval shunt for portal hypertensive variceal rebleeding after periesophagastric devascularization.Method In this study 18 patients with recurrent bleeding after devascularization underwent distal splenocaval shunt.Clinical data and follow-up result were collected and analyzed.Result The free portal pressure decreased from (35.6 ±3.8) cm H2O before shunting to (26.9 ±2.7) cm H2O after shunting.The operative mortality was 0.Liver function after postoperative second day changed significantly comparing to preoperative levels and it recovered to pre-operative level after 7 days.The rate of rebleeding and ascites was 17％ and 44％ respectively.There were 2 patients suffering from postshunt hepatic encephalopathy and the 2-year survival rate was 94.4％.Conclusions Distal splenocaval shunt could still be performed in portal hypertensive patients with recurrent variceal bleeding after periesophagastric devascularization with a patent splenic vein.