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[A new therapeutic concept for the selection of liver cirrhotics with recurrent bleeding esophageal varices for selective shunt].
Chirurg. 1979 May; 50(5):313-7.C

Abstract

Analysis was made of almost 600 patients who received shunt operations between January 1, 1952 and January 1, 1975 because of liver cirrhosis and repeated bleeding from gastroesophageal varices. The emergency portosystemic shunt was abandoned owing to its 50% lethality; the portocaval shunt was also discontinued, because of an encephalopathy rate of 25%. The splenorenal shunt (Linton) and coronary-caval shunt (Gütgemann) gave comparatively satisfactory results. A more recent introduction was the mesocaval interposition shunt (Drapanas). We also developed new criteria of indication for a shunt operation: elective shunt, liver volume 1000--2500 ml, portal vein perfusion 15%--40%, avoidance of celiac trunk and hepatic artery stenosis. Using only the types of shunt operation and criteria of indication here recommended, lethality among 65 patients operated on between January 1, 1975 and July 1, 1978 was only 6%, delayed lethality only 3%. The rate of encephalopathy was reduced to 5%. The 5-year life expectancy should increase to more than 70%. Thus, support is provided for the proposed therapy concept and criteria for shunt indication.

Authors

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Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

313324

Citation

Paquet, K J., et al. "[A New Therapeutic Concept for the Selection of Liver Cirrhotics With Recurrent Bleeding Esophageal Varices for Selective Shunt]." Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen, vol. 50, no. 5, 1979, pp. 313-7.
Paquet KJ, Thelen M, Koischwitz G, et al. [A new therapeutic concept for the selection of liver cirrhotics with recurrent bleeding esophageal varices for selective shunt]. Chirurg. 1979;50(5):313-7.
Paquet, K. J., Thelen, M., Koischwitz, G., & Biersack, H. J. (1979). [A new therapeutic concept for the selection of liver cirrhotics with recurrent bleeding esophageal varices for selective shunt]. Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen, 50(5), 313-7.
Paquet KJ, et al. [A New Therapeutic Concept for the Selection of Liver Cirrhotics With Recurrent Bleeding Esophageal Varices for Selective Shunt]. Chirurg. 1979;50(5):313-7. PubMed PMID: 313324.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A new therapeutic concept for the selection of liver cirrhotics with recurrent bleeding esophageal varices for selective shunt]. AU - Paquet,K J, AU - Thelen,M, AU - Koischwitz,G, AU - Biersack,H J, PY - 1979/5/1/pubmed PY - 1979/5/1/medline PY - 1979/5/1/entrez SP - 313 EP - 7 JF - Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen JO - Chirurg VL - 50 IS - 5 N2 - Analysis was made of almost 600 patients who received shunt operations between January 1, 1952 and January 1, 1975 because of liver cirrhosis and repeated bleeding from gastroesophageal varices. The emergency portosystemic shunt was abandoned owing to its 50% lethality; the portocaval shunt was also discontinued, because of an encephalopathy rate of 25%. The splenorenal shunt (Linton) and coronary-caval shunt (Gütgemann) gave comparatively satisfactory results. A more recent introduction was the mesocaval interposition shunt (Drapanas). We also developed new criteria of indication for a shunt operation: elective shunt, liver volume 1000--2500 ml, portal vein perfusion 15%--40%, avoidance of celiac trunk and hepatic artery stenosis. Using only the types of shunt operation and criteria of indication here recommended, lethality among 65 patients operated on between January 1, 1975 and July 1, 1978 was only 6%, delayed lethality only 3%. The rate of encephalopathy was reduced to 5%. The 5-year life expectancy should increase to more than 70%. Thus, support is provided for the proposed therapy concept and criteria for shunt indication. SN - 0009-4722 UR - https://www.unboundmedicine.com/medline/citation/313324/[A_new_therapeutic_concept_for_the_selection_of_liver_cirrhotics_with_recurrent_bleeding_esophageal_varices_for_selective_shunt]_ L2 - http://www.diseaseinfosearch.org/result/2658 DB - PRIME DP - Unbound Medicine ER -