Document Detail

Long-term evaluation of distal splenorenal shunt with splenopancreatic and gastric disconnection.
MedLine Citation:
PMID:  7604376     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study was aimed at evaluating advantages of distal splenorenal shunt (DSRS) with splenopancreatic and gastric disconnection (DSRS-SPGD) over DSRS with splenopancreatic disconnection (DSRS-SPD) and standard DSRS (S-DSRS). METHODS: DSRS-SPGD, DSRS-SPD, and S-DSRS were performed on 62, 7, and 55 patients, respectively, from 1970 to 1992. Comparison was performed in the following aspects: (1) long-term results in ratio of rebleeding, survival rate, and quality of life and (2) portal hemodynamics evaluated by preoperative and postoperative angiography. Portal blood flow was assessed by the ratio of the diameter of portal vein (PV) to superior mesenteric vein (SMV), and shunt selectivity was evaluated by selectivity grade. RESULTS: Incidence of rebleeding was significantly lower in patients who underwent DSRS-SPGD than in those who underwent S-DSRS (p < 0.05). Grade 0 and I performance status was better in patients who underwent DSRS-SPGD. Accumulated survival ratio for 5 and 7 years was 78.3% and 70.5% in patients who underwent DSRS-SPGD, 59.7% and 44.1% in patients who underwent S-DSRS, and 75% and 75% in patients who underwent DSRS-SPD. Hemodynamic evaluation showed significantly lower PV/SMV ratio and degree of change in PV/SMV ratio of patients who underwent S-DSRS and DSRS-SPD. Many patients who underwent S-DSRS and DSRS-SPD exhibited loss of shunt selectivity at grades II and III. In contrast, patients who underwent DSRS-SPGD maintained satisfactory PV/SMV ratio and selectivity grade. CONCLUSIONS: DSRS-SPGD clearly showed advantages in decrease of rebleeding and improvement of quality of life resulting from maintenance of shunt selectivity and portal blood flow.
S Kanaya; H Katoh
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  118     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1995 Jul 
Date Detail:
Created Date:  1995-08-07     Completed Date:  1995-08-07     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  29-35     Citation Subset:  AIM; IM    
Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
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MeSH Terms
Cause of Death
Esophageal and Gastric Varices / mortality,  surgery*
Follow-Up Studies
Hemorrhage / epidemiology
Middle Aged
Pancreas / surgery
Portasystemic Shunt, Surgical* / mortality
Quality of Life
Spleen / surgery
Splenorenal Shunt, Surgical* / mortality
Stomach / surgery*
Survival Rate

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

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