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Narrow-diameter portacaval shunts for management of variceal bleeding.
World J Surg. 1994 Mar-Apr; 18(2):211-5.WJ

Abstract

Over the past decade, we have developed and refined a method for partial portosystemic shunting for the control of bleeding esophageal varices in alcoholic cirrhotic patients. The narrow-diameter interposition portacaval H-graft using 8 mm polytetrafluoroethylene has been performed in 32 patients at our institution with low operative mortality (6.3%) and nearly complete cessation of variceal bleeding (96.7%) over a mean follow-up period of 43 months. In comparison with total shunts, diminished rates of postshunt encephalopathy (13% versus 40%) have been observed. Prograde portal blood flow has been preserved in 90% of 30 patients studied by perioperative portography. Shunt patency with continued prograde flow has been demonstrated at up to 9 years of follow-up. Investigators at three other centers have studied partial shunting using substantially similar techniques, with similar findings. Based on these results, we conclude that narrow-diameter shunts provide effective, long-lasting treatment for variceal hemorrhage due to portal hypertension in the alcoholic.

Authors+Show Affiliations

Collins JC
Surgical Service (112), Veterans Affairs Medical Center, Long Beach, California 90822.
Rypins EB
No affiliation info available
Sarfeh IJ
No affiliation info available

MeSH

Blood Vessel ProsthesisEsophageal and Gastric VaricesFollow-Up StudiesGastrointestinal HemorrhageHumansHypertension, PortalLiver Cirrhosis, AlcoholicPolytetrafluoroethylenePortacaval Shunt, SurgicalProsthesis DesignRecurrenceSurvival Rate

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

8042325

Citation

Collins, J C., et al. "Narrow-diameter Portacaval Shunts for Management of Variceal Bleeding." World Journal of Surgery, vol. 18, no. 2, 1994, pp. 211-5.
Collins JC, Rypins EB, Sarfeh IJ. Narrow-diameter portacaval shunts for management of variceal bleeding. World J Surg. 1994;18(2):211-5.
Collins, J. C., Rypins, E. B., & Sarfeh, I. J. (1994). Narrow-diameter portacaval shunts for management of variceal bleeding. World Journal of Surgery, 18(2), 211-5.
Collins JC, Rypins EB, Sarfeh IJ. Narrow-diameter Portacaval Shunts for Management of Variceal Bleeding. World J Surg. 1994 Mar-Apr;18(2):211-5. PubMed PMID: 8042325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Narrow-diameter portacaval shunts for management of variceal bleeding. AU - Collins,J C, AU - Rypins,E B, AU - Sarfeh,I J, PY - 1994/3/1/pubmed PY - 1994/3/1/medline PY - 1994/3/1/entrez SP - 211 EP - 5 JF - World journal of surgery JO - World J Surg VL - 18 IS - 2 N2 - Over the past decade, we have developed and refined a method for partial portosystemic shunting for the control of bleeding esophageal varices in alcoholic cirrhotic patients. The narrow-diameter interposition portacaval H-graft using 8 mm polytetrafluoroethylene has been performed in 32 patients at our institution with low operative mortality (6.3%) and nearly complete cessation of variceal bleeding (96.7%) over a mean follow-up period of 43 months. In comparison with total shunts, diminished rates of postshunt encephalopathy (13% versus 40%) have been observed. Prograde portal blood flow has been preserved in 90% of 30 patients studied by perioperative portography. Shunt patency with continued prograde flow has been demonstrated at up to 9 years of follow-up. Investigators at three other centers have studied partial shunting using substantially similar techniques, with similar findings. Based on these results, we conclude that narrow-diameter shunts provide effective, long-lasting treatment for variceal hemorrhage due to portal hypertension in the alcoholic. SN - 0364-2313 UR - https://www.unboundmedicine.com/medline/citation/8042325/Narrow_diameter_portacaval_shunts_for_management_of_variceal_bleeding_ L2 - https://medlineplus.gov/gastrointestinalbleeding.html DB - PRIME DP - Unbound Medicine ER -