Tags

Type your tag names separated by a space and hit enter

Transjugular intrahepatic portosystemic shunt versus distal splenorenal shunt--a comparative study.
Hepatogastroenterology. 2000 Mar-Apr; 47(32):492-7.H

Abstract

BACKGROUND/AIMS

No general consensus exists regarding the proper surgical management of recurrent variceal bleeding due to hepatic cirrhosis. Transjugular intrahepatic portosystemic shunt and distal splenorenal shunt are increasingly being performed in the management of these patients. The present study was undertaken to compare the efficacy, complications and survival rate of these two procedures.

METHODOLOGY

Sixty-seven patients with alcoholic liver cirrhosis of Child-Pugh's class A (n = 22) and class B (n = 45) with recurrent variceal bleeding not controlled by conservative means underwent either transjugular intrahepatic portosystemic shunt placement (n = 35) or a distal splenorenal shunt operation (n = 32). These patients were followed for a mean of 887 +/- 189 days. Both groups were compared with respect to the rates of survival, recurrence of gastrointestinal bleeding, encephalopathy, ascitis, shunt blockade and other relevant biochemical parameters.

RESULTS

Patients who underwent a distal splenorenal shunt operation had lower rates of recurrence of gastrointestinal bleeding (6.25% vs. 25.71%), encephalopathy (18.75% vs. 42.86%) shunt blockade (6.25% vs. 68.57%) and lower mean fasting blood ammonia levels (56.70 +/- 7.10 mumol/L vs. 61.70 +/- 5.70 mumol/L). However the rate of ascitis was higher amongst these patients (40.63% vs. 11.43%). There was no significant difference in the midterm survival rates between these groups (81.25% vs. 80.00%). Both procedures were effective in controlling functional renal failure, splenomegaly and features of hypersplenism.

CONCLUSIONS

Distal splenorenal shunt operation is a better therapeutic option than transjugular intrahepatic portosystemic shunt placement for control of recurrent variceal bleeding due to hepatic cirrhosis.

Authors+Show Affiliations

Department of Gastroenterology, Suchitra Memorial Hospital, New Delhi, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

10791220

Citation

Khaitiyar, J S., et al. "Transjugular Intrahepatic Portosystemic Shunt Versus Distal Splenorenal Shunt--a Comparative Study." Hepato-gastroenterology, vol. 47, no. 32, 2000, pp. 492-7.
Khaitiyar JS, Luthra SK, Prasad N, et al. Transjugular intrahepatic portosystemic shunt versus distal splenorenal shunt--a comparative study. Hepatogastroenterology. 2000;47(32):492-7.
Khaitiyar, J. S., Luthra, S. K., Prasad, N., Ratnakar, N., & Daruwala, D. K. (2000). Transjugular intrahepatic portosystemic shunt versus distal splenorenal shunt--a comparative study. Hepato-gastroenterology, 47(32), 492-7.
Khaitiyar JS, et al. Transjugular Intrahepatic Portosystemic Shunt Versus Distal Splenorenal Shunt--a Comparative Study. Hepatogastroenterology. 2000 Mar-Apr;47(32):492-7. PubMed PMID: 10791220.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transjugular intrahepatic portosystemic shunt versus distal splenorenal shunt--a comparative study. AU - Khaitiyar,J S, AU - Luthra,S K, AU - Prasad,N, AU - Ratnakar,N, AU - Daruwala,D K, PY - 2000/5/3/pubmed PY - 2000/7/25/medline PY - 2000/5/3/entrez SP - 492 EP - 7 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 47 IS - 32 N2 - BACKGROUND/AIMS: No general consensus exists regarding the proper surgical management of recurrent variceal bleeding due to hepatic cirrhosis. Transjugular intrahepatic portosystemic shunt and distal splenorenal shunt are increasingly being performed in the management of these patients. The present study was undertaken to compare the efficacy, complications and survival rate of these two procedures. METHODOLOGY: Sixty-seven patients with alcoholic liver cirrhosis of Child-Pugh's class A (n = 22) and class B (n = 45) with recurrent variceal bleeding not controlled by conservative means underwent either transjugular intrahepatic portosystemic shunt placement (n = 35) or a distal splenorenal shunt operation (n = 32). These patients were followed for a mean of 887 +/- 189 days. Both groups were compared with respect to the rates of survival, recurrence of gastrointestinal bleeding, encephalopathy, ascitis, shunt blockade and other relevant biochemical parameters. RESULTS: Patients who underwent a distal splenorenal shunt operation had lower rates of recurrence of gastrointestinal bleeding (6.25% vs. 25.71%), encephalopathy (18.75% vs. 42.86%) shunt blockade (6.25% vs. 68.57%) and lower mean fasting blood ammonia levels (56.70 +/- 7.10 mumol/L vs. 61.70 +/- 5.70 mumol/L). However the rate of ascitis was higher amongst these patients (40.63% vs. 11.43%). There was no significant difference in the midterm survival rates between these groups (81.25% vs. 80.00%). Both procedures were effective in controlling functional renal failure, splenomegaly and features of hypersplenism. CONCLUSIONS: Distal splenorenal shunt operation is a better therapeutic option than transjugular intrahepatic portosystemic shunt placement for control of recurrent variceal bleeding due to hepatic cirrhosis. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/10791220/Transjugular_intrahepatic_portosystemic_shunt_versus_distal_splenorenal_shunt__a_comparative_study_ L2 - https://medlineplus.gov/gastrointestinalbleeding.html DB - PRIME DP - Unbound Medicine ER -