Document Detail


Long-term efficacy of distal splenorenal shunt with splenopancreatic and gastric disconnection for esophagogastric varices in patients with idiopathic portal hypertension.
MedLine Citation:
PMID:  15977080     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Idiopathic portal hypertension (IPH) requires invasive measures to prevent rupture and bleeding of esophagogastric varices. However, the long-term results of shunt surgery for IPH have not been reported. In particular, the pros and cons of surgery that preserves the spleen and its long-term hematologic effects have not been described. The records of 15 patients who underwent distal splenorenal shunt with splenopancreatic and gastric disconnection (DSRS with SPGD) for IPH between 1983 and 1998 was reviewed retrospectively. One patient died within 3 years of surgery, for a 3-year survival rate of 93%; the 10-year survival rate was 64%. Three patients (18%) suffered rebleeding from esophagogastric varices. The white blood cell and platelet counts were higher 3-5 years and 7-13 years postoperatively compared with preoperative values. Four of five patients who underwent postoperative computed tomography had a smaller spleen postoperatively. DSRS with SPGD provides long-term hemostasis for esophagogastric variceal bleeding in IPH and alleviates hypersplenism. DSRS with SPGD is an effective treatment for patients with IPH in whom long-term survival is expected.
Authors:
Ryunosuke Hase; Satoshi Hirano; Satoshi Kondo; Shunichi Okushiba; Toshiaki Morikawa; Hiroyuki Katoh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  29     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-10-06     Completed Date:  2005-11-09     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1034-6; discussion 1037     Citation Subset:  IM    
Affiliation:
Surgical Oncology, Cancer Medicine, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan. ryu-hase@med.hokudai.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Esophageal and Gastric Varices / etiology,  surgery*
Female
Humans
Hypertension, Portal / complications*
Male
Middle Aged
Retrospective Studies
Splenorenal Shunt, Surgical / methods*,  mortality
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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