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Long-term results after modified distal splenorenal shunt with expanded PTFE interposition.
Zentralbl Chir. 1992; 117(1):24-9.ZC

Abstract

Forty consecutive patients with esophagogastric varices underwent a modified distal splenorenal shunt with expanded polytetrafluoroethylene (PTFE) interposition and were followed up for 12 to 66 months (mean 44.7). The operations were urgent in 9, elective in 14, and prophylactic in 17 patients. There were 24 males and 16 females. Age ranged from 32 to 76 years with an average of 53.8. The causes of portal hypertension were liver cirrhosis in 32, chronic hepatitis in 4, idiopathic portal hypertension in 3, and primary biliary cirrhosis in 1. Twenty-six patients were in Child's class A, 6 in class B, and 8 in class C. The operative death rate within 1 month was 2.5% and the overall in-hospital mortality rate was 5%. The shunt patency rate was 97.2% at early and 100% at late examinations. Only one patient (2.5%) had upper gastrointestinal bleeding. Hepatic encephalopathy was seen in 8 (20.5%) of 39 surviving patients. Six patients died of liver failure and another six died from various causes during the follow-up period. Twenty-six patients (65%) are alive at present. The 1-, 3-, and 5-year cumulative survival rates were 87.4%, 73.3% and 48.8%, respectively. The current modified shunt can be carried out more safely and easily and yield a similar result to that with the original Warren shunt. In order to avoid hepatic encephalopathy and liver failure, however, it is not wise to persist in this procedure.

Authors+Show Affiliations

Second Department of Surgery, Shimane Medical University, Izumo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

1546495

Citation

Nagasue, N, et al. "Long-term Results After Modified Distal Splenorenal Shunt With Expanded PTFE Interposition." Zentralblatt Fur Chirurgie, vol. 117, no. 1, 1992, pp. 24-9.
Nagasue N, Ogawa Y, Yukaya H, et al. Long-term results after modified distal splenorenal shunt with expanded PTFE interposition. Zentralbl Chir. 1992;117(1):24-9.
Nagasue, N., Ogawa, Y., Yukaya, H., Kohno, H., Chang, Y. C., Hayashi, T., Yamanoi, A., & Nakamura, T. (1992). Long-term results after modified distal splenorenal shunt with expanded PTFE interposition. Zentralblatt Fur Chirurgie, 117(1), 24-9.
Nagasue N, et al. Long-term Results After Modified Distal Splenorenal Shunt With Expanded PTFE Interposition. Zentralbl Chir. 1992;117(1):24-9. PubMed PMID: 1546495.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term results after modified distal splenorenal shunt with expanded PTFE interposition. AU - Nagasue,N, AU - Ogawa,Y, AU - Yukaya,H, AU - Kohno,H, AU - Chang,Y C, AU - Hayashi,T, AU - Yamanoi,A, AU - Nakamura,T, PY - 1992/1/1/pubmed PY - 1992/1/1/medline PY - 1992/1/1/entrez SP - 24 EP - 9 JF - Zentralblatt fur Chirurgie JO - Zentralbl Chir VL - 117 IS - 1 N2 - Forty consecutive patients with esophagogastric varices underwent a modified distal splenorenal shunt with expanded polytetrafluoroethylene (PTFE) interposition and were followed up for 12 to 66 months (mean 44.7). The operations were urgent in 9, elective in 14, and prophylactic in 17 patients. There were 24 males and 16 females. Age ranged from 32 to 76 years with an average of 53.8. The causes of portal hypertension were liver cirrhosis in 32, chronic hepatitis in 4, idiopathic portal hypertension in 3, and primary biliary cirrhosis in 1. Twenty-six patients were in Child's class A, 6 in class B, and 8 in class C. The operative death rate within 1 month was 2.5% and the overall in-hospital mortality rate was 5%. The shunt patency rate was 97.2% at early and 100% at late examinations. Only one patient (2.5%) had upper gastrointestinal bleeding. Hepatic encephalopathy was seen in 8 (20.5%) of 39 surviving patients. Six patients died of liver failure and another six died from various causes during the follow-up period. Twenty-six patients (65%) are alive at present. The 1-, 3-, and 5-year cumulative survival rates were 87.4%, 73.3% and 48.8%, respectively. The current modified shunt can be carried out more safely and easily and yield a similar result to that with the original Warren shunt. In order to avoid hepatic encephalopathy and liver failure, however, it is not wise to persist in this procedure. SN - 0044-409X UR - https://www.unboundmedicine.com/medline/citation/1546495/Long_term_results_after_modified_distal_splenorenal_shunt_with_expanded_PTFE_interposition_ DB - PRIME DP - Unbound Medicine ER -