Document Detail


The distal lienorenal shunt: perioperative experience with 30 patients.
MedLine Citation:
PMID:  6973969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
During the past 51/2 years, thirty consecutive and unselected patients who bled from oesophageal varices underwent distal lienorenal shunt surgery. Eight deaths occurred in the immediate postoperative period. Three of nine emergency patients died because of continued bleeding and, of the five elective patients who died, four were largely the result of technical problems encountered at surgery. In the immediate postoperative period variceal bleeding recurred in five of eight emergency patients despite shunt patency. This did not occur in the elective group. Shunt blockage was relatively common compared to that following conventional porta-systemic shunt surgery; being documented in five of the 24 patients in whom patency was assessed. No clinical, biochemical or histological criteria were identified as predictors of outcome. In particular, the presence of preoperative ascites gave no indication of postoperative problems. However, if ascites developed in the immediate postoperative period, it was a major management problem in 50% of patients. In conclusion, the distal lienorenal shunt has a high perioperative mortality, is commonly complicated by shunt thrombosis and, in the emergency situation, often fails to control bleeding. The technical difficulties encountered at surgery appear largely responsible for the early morbidity and mortality.
Authors:
P R Gibson; I E McInnes; D S Rosengarten; A W Jakobovits; D A Coventry; F J Dudley
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Australian and New Zealand journal of surgery     Volume:  51     ISSN:  0004-8682     ISO Abbreviation:  Aust N Z J Surg     Publication Date:  1981 Aug 
Date Detail:
Created Date:  1981-10-29     Completed Date:  1981-10-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0373115     Medline TA:  Aust N Z J Surg     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  336-40     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Esophageal and Gastric Varices / complications,  surgery*
Female
Gastrointestinal Hemorrhage / etiology,  surgery
Humans
Male
Methods
Middle Aged
Portasystemic Shunt, Surgical*
Postoperative Complications / mortality
Preoperative Care
Splenorenal Shunt, Surgical*

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


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