| Small-diameter prosthetic H-graft portacaval shunt: definitive therapy for variceal bleeding. | |
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MedLine Citation:
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PMID: 10457318 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Partial portal decompression has become a popular option in the treatment of complicated portal hypertension. This study was undertaken to report long-term follow-up after partial portal decompression obtained utilizing 8 mm prosthetic H-graft portacaval shunts. A total of 110 consecutive patients underwent H-graft portacaval shunting through a protocol that detailed care and studies from 1988 to 1996. Prospective follow-up recorded efficacy of partial portal decompression, shunt patency, morbidity of shunting, and survival. Seventy males and 40 females, whose average age was 54 +/-12.7 years (standard deviation), underwent shunting. Cirrhosis was due to alcohol abuse in 64%. Fourteen percent were in Child's class A, 55% in Child's class B, and 31% in Child's class C. Shunts were undertaken as emergencies in 20%, urgently in 13%, and electively in 67%. Shunting decreased portal pressure in all patients (30 +/-5.3 Hg to 19.9 -/+5.5 mm Hg; P <0.001). Early and late thrombosis was 6.4% and 3.6%, respectively. Late rebleeding occurred in 5.4%. Perioperative (30-day) mortality was 11.8%, and was highest for patients in Child's class C. Three-year survival was 53%. Five-year survival was 41%. Partial portal decompression is achieved with H-graft portacaval shunting. Rebleeding, shunt occlusion, and encephalopathy are uncommon. In this series of unselected older patients with alcoholic cirrhosis, 5-year survival after H-graft portacaval shunting was greater than 40% with minimal intervention. |
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Authors:
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A S Rosemurgy; F M Serafini; E E Zervos; S E Goode |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: 2 ISSN: 1091-255X ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 1998 Nov-Dec |
Date Detail:
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Created Date: 1999-10-07 Completed Date: 1999-10-07 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 585-91 Citation Subset: IM |
Affiliation:
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Division of Surgical Digestive Disorders, Tampa General Hospital, Department of Surgery, University of South Florida College of Medicine 33601, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Blood Vessel Prosthesis Implantation Esophageal and Gastric Varices / complications*, etiology Female Gastrointestinal Hemorrhage / etiology, surgery* Humans Liver Cirrhosis, Alcoholic / complications* Male Middle Aged Portacaval Shunt, Surgical* Postoperative Complications Prospective Studies Survival Rate Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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