Long-term results of small-diameter proximal splenorenal venous shunt：A retrospective study

• Published in: World journal of gastroenterology : WJG Vol. 17; no. 29; pp. 3453 - 3458
• Main Authors: Chen, Hao, Yang, Wei-Ping, Yan, Ji-Qi, Li, Qin-Yu, Ma, Di, Li, Hong-Wei
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 07.08.2011
• Subjects: Adult; Aged; Brief; Esophageal and Gastric Varices - complications; Esophageal and Gastric Varices - surgery; Female; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - prevention & control; Gastrointestinal Hemorrhage - surgery; Hemodynamics; Humans; Male; Middle Aged; Recurrence; Retrospective Studies; Splenorenal Shunt, Surgical - methods; Survival Rate; Treatment Outcome; Young Adult; 分流; 多普勒超声; 小直径; 死亡率; 肝性脑病; 肾; 脾; 静脉曲张; Shunt diameter; Hemorrhage; Partial portacaval shunt; Encephalopathy; Esophageal varices
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v17.i29.3453

AIM：To investigate recurrent variceal hemorrhage and long-term survival rates of patients treated with partial proximal splenorenal venous shunt.METHODS：Patients with variceal hemorrhage who were treated with small-diameter proximal splenorenal venous shunt in Ruijin Hospital between 1996 and 2009 were included in this study.Shunt diameter was determined before operation using Duplex Doppler ultrasonography.Peri-operative and long-term results in term of rehemorrhage,encephalopathy and mortality were followed up.RESULTS：Ninety-eight patients with Child A and B variceal hemorrhage received small-diameter proximal splenorenal venous shunt with a diameter of 7-10 mm.After operation,the patients’mean free portal pressure （P0.01）and the flow rate of main portal vein（P 0.01）decreased significantly compared with that before operation.The rates of rebleeding and mortality were 6.12%（6 cases）and 2.04%（2 cases）,respectively.Ninety-one patients were followed up for 7 mo-14 years （median,48.57 mo）.Long-term rates of rehemorrhage and encephalopathy were 4.40%（4 cases）and 3.30% （3 cases）,respectively.Thirteen patients（14.29%）died mainly due to progressive hepatic dysfunction.Fiveand ten-year survival rates were 82.12%and 71.24%,respectively.CONCLUSION：Small-diameter proximal splenorenal venous shunt affords protection against variceal rehemorrhage with a low occurrence of encephalopathy in patients with normal liver function.