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Appraisal of distal splenorenal shunt in the treatment of esophageal varices: an analysis of prophylactic, emergency, and elective shunts.
World J Surg. 1989 Jan-Feb; 13(1):92-9; discussion 99.WJ

Abstract

From June, 1969 to February, 1987, distal splenorenal shunt was carried out on 78 patients with esophagogastric varices. The operations were urgent in 9, elective in 40, and prophylactic in 29 patients. There were 52 males and 26 females. Age ranged from 16 to 76 years with an average of 53 years. Thirty-seven patients were alcoholics. Hepatitis B surface antigen was positive in only 15.5%. The causes of portal hypertension were cirrhosis of the liver in 67, chronic hepatitis in 5, idiopathic portal hypertension in 4, primary biliary cirrhosis in 1, and fatty liver in 1 patient. Fifty-two patients were in Child's class A, 18 in class B, and 8 in class C. Emergency shunts were performed only when conservative therapy had failed to stop variceal bleeding. Prophylactic operations were done in patients having Child's class A or class B liver disease and risky varices, in varices larger than 5 mm in diameter and/or varices with red color signs such as cherry red spots. Forty-two patients underwent the original Warren shunt, but the remaining 36 had modified distal splenorenal shunt with expanded polytetrafluoroethylene interposition. The operative mortality rates were 11.1% in the emergency group, 2.5% in the elective group, and 3.4% in the prophylactic group. The overall operative and hospital death rates were 3.8% and 7.7%, respectively. The patency rate was 94.1% and the incidence of rebleeding from esophageal varices was 3.8%. Hepatic encephalopathy, although mild to moderate in degree, was observed in 14.7% of 75 patients excluding 3 operative deaths.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

2786285

Citation

Nagasue, N, et al. "Appraisal of Distal Splenorenal Shunt in the Treatment of Esophageal Varices: an Analysis of Prophylactic, Emergency, and Elective Shunts." World Journal of Surgery, vol. 13, no. 1, 1989, pp. 92-9; discussion 99.
Nagasue N, Kohno H, Ogawa Y, et al. Appraisal of distal splenorenal shunt in the treatment of esophageal varices: an analysis of prophylactic, emergency, and elective shunts. World J Surg. 1989;13(1):92-9; discussion 99.
Nagasue, N., Kohno, H., Ogawa, Y., Yukaya, H., Tamada, R., Sasaki, Y., Chang, Y. C., & Nakamura, T. (1989). Appraisal of distal splenorenal shunt in the treatment of esophageal varices: an analysis of prophylactic, emergency, and elective shunts. World Journal of Surgery, 13(1), 92-9; discussion 99.
Nagasue N, et al. Appraisal of Distal Splenorenal Shunt in the Treatment of Esophageal Varices: an Analysis of Prophylactic, Emergency, and Elective Shunts. World J Surg. 1989 Jan-Feb;13(1):92-9; discussion 99. PubMed PMID: 2786285.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Appraisal of distal splenorenal shunt in the treatment of esophageal varices: an analysis of prophylactic, emergency, and elective shunts. AU - Nagasue,N, AU - Kohno,H, AU - Ogawa,Y, AU - Yukaya,H, AU - Tamada,R, AU - Sasaki,Y, AU - Chang,Y C, AU - Nakamura,T, PY - 1989/1/1/pubmed PY - 1989/1/1/medline PY - 1989/1/1/entrez SP - 92-9; discussion 99 JF - World journal of surgery JO - World J Surg VL - 13 IS - 1 N2 - From June, 1969 to February, 1987, distal splenorenal shunt was carried out on 78 patients with esophagogastric varices. The operations were urgent in 9, elective in 40, and prophylactic in 29 patients. There were 52 males and 26 females. Age ranged from 16 to 76 years with an average of 53 years. Thirty-seven patients were alcoholics. Hepatitis B surface antigen was positive in only 15.5%. The causes of portal hypertension were cirrhosis of the liver in 67, chronic hepatitis in 5, idiopathic portal hypertension in 4, primary biliary cirrhosis in 1, and fatty liver in 1 patient. Fifty-two patients were in Child's class A, 18 in class B, and 8 in class C. Emergency shunts were performed only when conservative therapy had failed to stop variceal bleeding. Prophylactic operations were done in patients having Child's class A or class B liver disease and risky varices, in varices larger than 5 mm in diameter and/or varices with red color signs such as cherry red spots. Forty-two patients underwent the original Warren shunt, but the remaining 36 had modified distal splenorenal shunt with expanded polytetrafluoroethylene interposition. The operative mortality rates were 11.1% in the emergency group, 2.5% in the elective group, and 3.4% in the prophylactic group. The overall operative and hospital death rates were 3.8% and 7.7%, respectively. The patency rate was 94.1% and the incidence of rebleeding from esophageal varices was 3.8%. Hepatic encephalopathy, although mild to moderate in degree, was observed in 14.7% of 75 patients excluding 3 operative deaths.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0364-2313 UR - https://www.unboundmedicine.com/medline/citation/2786285/Appraisal_of_distal_splenorenal_shunt_in_the_treatment_of_esophageal_varices:_an_analysis_of_prophylactic_emergency_and_elective_shunts_ L2 - http://www.diseaseinfosearch.org/result/2658 DB - PRIME DP - Unbound Medicine ER -