| Long-term evaluation of distal splenorenal shunt with splenopancreatic and gastric disconnection. | |
MedLine Citation:
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PMID: 7604376 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
Authors:
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S Kanaya; H Katoh |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Surgery Volume: 118 ISSN: 0039-6060 ISO Abbreviation: Surgery Publication Date: 1995 Jul |
Date Detail:
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Created Date: 1995-08-07 Completed Date: 1995-08-07 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 29-35 Citation Subset: AIM; IM |
Affiliation:
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Second Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cause of Death Esophageal and Gastric Varices / mortality, surgery* Female Follow-Up Studies Hemorrhage / epidemiology Humans Male Middle Aged Pancreas / surgery Portasystemic Shunt, Surgical* / mortality Quality of Life Recurrence 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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