Side-to-side Meso-caval Shunt
- VernacularTitle:肠系膜上静脉下腔静脉侧侧分流术
- Author:
Zhiqiang HUANG
;
Jingxiu CAI
- Publication Type:Journal Article
- From:Journal of Third Military Medical University
1983;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Side-to-side meso-caval shunt is one of the peripheral porto-systemic shunts that can retain a part of the portal blood flow passing through the hepatic vascular bed. It has the advantages of simple operative maneuver and limited operative traumatism. Furthermore it can maintain the continuity of the inferior vena cave.This type of operation was performed on 24 patients with portal hypertension of different causes from 1963 to October, 1980- There was no immediate operative mortality. One case was complicated with chylous ascites postopera-tively. A second operation failed to correct the condition and the patient died of progressive exhaustion about one month later.Among the follow-up cases, four cases developed hepatoencephalopathy four to seven years later respectively; six cases developed recurrent digestive bleeding within 5 years after the shunt operation.The indications of this operation are: ( 1 ) slender body type;(2)no large amount of ascites; ( 3 ) bleeding after splenectomy; (4) no thrombosis or phlebitis of the superior mesenteric vein;(5)no enlargement of the pancreas; (6) a sufficient length of the main trunk of the superior mesenteric vein; ( 7 ) the distance between the superior mesenteric vein and the inferior vena cava is not too long.If there is a recent history of G-I bleeding, the coronary vein of the stomach should be ligated when the patient is being operated on. Whenever the anatomy of the regional veins is not suitable for this kind of operation, an interposing autogenous internal jugular vein graft had better be used.
