Selection of patients with portal hypertension for splenorenal shunt

D. P. Campbell, C. E. Anagnostopoulos, W. W.L. Glenn

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4 Scopus citations

Abstract

76 portal systemic shunts for portal hypertension complicated by bleeding esophageal varices are presented. 22 patients had splenectomy and splenorenal anastomoses and 54 had portacaval anastomoses performed. The indications for performing a splenorenal shunt were extrahepatic obstruction, severe hypersplenism, technical problems preventing portacaval anastomosis, combined intra and extrahepatic portal obstruction and portal hypertension without demonstrable obstruction. 5 yr follow up data of the patients with cirrhosis who had splenorenal shunts performed were compared with those of patients with cirrhosis who had portacaval shunts performed. In terms of operative mortality, postoperative ammonia intoxication, 5 yr survival and quality of survival, the results in the patients with splenorenal shunts were superior to those in patients with portacaval shunts. On the basis of these results and in view of other considerations concerning the preservation of intrahepatic blood flow, the authors believe the splenorenal shunt is the procedure of choice in the above groups of patients when a suitable splenic vein is available for splenorenal anastomosis. Although all the patients who have undergone splenorenal and portacaval shunts are not comparable, the superior results obtained with the splenorenal shunt suggest that it may be the procedure of choice in most patients requiring portal systemic shunting.

Original languageEnglish
Pages (from-to)70-74
Number of pages5
JournalAnnals of Surgery
Volume178
Issue number1
DOIs
StatePublished - 1973
Externally publishedYes

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