Abstract
A method is proposed to reduce portal hypertension utilizing subtotal splenectomy and a central splenorenal shunt. The advantages of this method are: diversion of the splenic component of the portal circulation, creation of a shunt for the portal blood into the systemic circulation, preservation of the splenic function and correction of the manifestations of the hypersplenism. Two cases are presented who remain well four years after surgery.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Armas R., Thakur M. L., Gottschalk A. A simple method of spleen imaging with 99mTc-labeled erythrocytes. Radiology. 1979 Jul;132(1):215–216. doi: 10.1148/132.1.215. [DOI] [PubMed] [Google Scholar]
- BLAKEMORE A. H. Portacaval shunting for portal hypertension. Surg Gynecol Obstet. 1952 Apr;94(4):443–454. [PubMed] [Google Scholar]
- Cello J. P., Grendell J. H., Crass R. A., Weber T. E., Trunkey D. D. Endoscopic sclerotherapy versus portacaval shunt in patient with severe cirrhosis and acute variceal hemorrhage. Long-term follow-up. N Engl J Med. 1987 Jan 1;316(1):11–15. doi: 10.1056/NEJM198701013160103. [DOI] [PubMed] [Google Scholar]
- Gibson P. R., McInnes I. E., Dudley F. J. The long-term effect of distal lienorenal shunt surgery on portal venous pressure. Aust N Z J Surg. 1986 Oct;56(10):773–776. doi: 10.1111/j.1445-2197.1986.tb02324.x. [DOI] [PubMed] [Google Scholar]
- Gonzalez E. M., Martin J. H., Abella P. C., Aguyo J. L., Jelavik D. Interposition left gastric-caval shunt using internal jugular vein autograft in the treatment of portal hypertension. Br J Surg. 1978 Feb;65(2):115–117. doi: 10.1002/bjs.1800650213. [DOI] [PubMed] [Google Scholar]
- Henderson J. M., Warren W. D. Selective variceal decompression: current status and recent advances. Adv Surg. 1984;18:81–115. [PubMed] [Google Scholar]
- Inokuchi K., Kobayashi M., Kusaba A., Ogawa Y., Saku M., Shiizaki T. New selective decompression of esophageal varices. By a left gastric venous-caval shunt. Arch Surg. 1970 Feb;100(2):157–162. doi: 10.1001/archsurg.1970.01340200045011. [DOI] [PubMed] [Google Scholar]
- Korula J., Balart L. A., Radvan G., Zweiban B. E., Larson A. W., Kao H. W., Yamada S. A prospective, randomized controlled trial of chronic esophageal variceal sclerotherapy. Hepatology. 1985 Jul-Aug;5(4):584–589. doi: 10.1002/hep.1840050410. [DOI] [PubMed] [Google Scholar]
- Moriyasu F., Nishida O., Ban N., Nakamura T., Tamada T., Kawasaki T., Sakai M., Miyake T., Kumada K., Ozawa K. Ultrasonic Doppler duplex study of hemodynamic changes from portosystemic shunt operation. Ann Surg. 1987 Feb;205(2):151–156. doi: 10.1097/00000658-198702000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sarles H. E., Jr, Sanowski R. A., Talbert G. Course and complications of endoscopic variceal sclerotherapy: a prospective study of 50 patients. Am J Gastroenterol. 1985 Aug;80(8):595–599. [PubMed] [Google Scholar]
- Slim M. S., Najjar N. E., Mishalany H. G. Preservation of the injured spleen. Br J Surg. 1979 Sep;66(9):671–672. doi: 10.1002/bjs.1800660925. [DOI] [PubMed] [Google Scholar]
- Terés J., Baroni R., Bordas J. M., Visa J., Pera C., Rodés J. Randomized trial of portacaval shunt, stapling transection and endoscopic sclerotherapy in uncontrolled variceal bleeding. J Hepatol. 1987 Apr;4(2):159–167. doi: 10.1016/s0168-8278(87)80075-2. [DOI] [PubMed] [Google Scholar]
- Warren W. D., Henderson J. M., Millikan W. J., Galambos J. T., Brooks W. S., Riepe S. P., Salam A. A., Kutner M. H. Distal splenorenal shunt versus endoscopic sclerotherapy for long-term management of variceal bleeding. Preliminary report of a prospective, randomized trial. Ann Surg. 1986 May;203(5):454–462. doi: 10.1097/00000658-198605000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]