BIOMAT Database Logo BIOMAT Database Logo

[Clinical results of selective distal splenorenal and latero-lateral portacaval anastomoses. Comparative prospective study of 93 patients]. 1991

G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
Università di Milano, Clinica Chirurgica I., Ospedale Policlinico, Italie.

The distal splenorenal shunt (DSRS) was compared with the side-t-side portacaval shunt (PCS) in 93 prospectively matched cirrhotic patients with portal hypertension. After a mean follow-up of 38 months, no differences were observed in operative mortality, long term survival and variceal rebleeding between the two groups. There was no significant difference in terms of acute encephalopathy (22% in PCS group and 33% in DSRS group) and chronic encephalopathy (35% in PCS and 17% in DSRS). However, the only cases of severe and disabling chronic encephalopathy (CE) arose after PCS (p = 0.049). Actuarial curves of CE showed that the maximum rate of this complication (18%) in the DSRS group was reached 27 months after shunt surgery, whereas this value was reached and passed in PCS group only 4 months after shunt. CE occurred for a total duration of 20.1 months after PCS and only 11.1 months after DSRS (p = 0.003) and occupied 46.3% of the follow-up of PCS patients in contrast to 18.7% of the follow-up of DSRS patients (p = 0.001). DSRS is associated with a lower global incidence of CE without severe forms and provides a better quality of life than does a nonselective shunt.

UI MeSH Term Description Entries
D008103 Liver Cirrhosis Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. Cirrhosis, Liver,Fibrosis, Liver,Hepatic Cirrhosis,Liver Fibrosis,Cirrhosis, Hepatic
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011167 Portacaval Shunt, Surgical Surgical portasystemic shunt between the portal vein and inferior vena cava. Eck Fistula,Portacaval Anastomosis,Portacaval Shunt,Shunt, Surgical Portacaval,Surgical Portacaval Shunt,Anastomoses, Portacaval,Anastomosis, Portacaval,Fistula, Eck,Portacaval Anastomoses,Portacaval Shunts,Portacaval Shunts, Surgical,Shunt, Portacaval,Shunts, Portacaval,Shunts, Surgical Portacaval,Surgical Portacaval Shunts
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D004932 Esophageal and Gastric Varices Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL). Esophageal Varices,Gastric Varices,Esophageal Varix,Gastric Varix,Varices, Esophageal,Varices, Gastric,Varix, Esophageal,Varix, Gastric
D005260 Female Females
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006501 Hepatic Encephalopathy A syndrome characterized by central nervous system dysfunction in association with LIVER FAILURE, including portal-systemic shunts. Clinical features include lethargy and CONFUSION (frequently progressing to COMA); ASTERIXIS; NYSTAGMUS, PATHOLOGIC; brisk oculovestibular reflexes; decorticate and decerebrate posturing; MUSCLE SPASTICITY; and bilateral extensor plantar reflexes (see REFLEX, BABINSKI). ELECTROENCEPHALOGRAPHY may demonstrate triphasic waves. (From Adams et al., Principles of Neurology, 6th ed, pp1117-20; Plum & Posner, Diagnosis of Stupor and Coma, 3rd ed, p222-5) Encephalopathy, Hepatic,Portosystemic Encephalopathy,Encephalopathy, Hepatocerebral,Encephalopathy, Portal-Systemic,Encephalopathy, Portosystemic,Fulminant Hepatic Failure with Cerebral Edema,Hepatic Coma,Hepatic Stupor,Hepatocerebral Encephalopathy,Portal-Systemic Encephalopathy,Coma, Hepatic,Comas, Hepatic,Encephalopathies, Hepatic,Encephalopathies, Hepatocerebral,Encephalopathies, Portal-Systemic,Encephalopathies, Portosystemic,Encephalopathy, Portal Systemic,Hepatic Comas,Hepatic Encephalopathies,Hepatic Stupors,Hepatocerebral Encephalopathies,Portal Systemic Encephalopathy,Portal-Systemic Encephalopathies,Portosystemic Encephalopathies,Stupor, Hepatic,Stupors, Hepatic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
[Study of latero-lateral portacaval anastomoses].
January 1962, Revue internationale d'hepatologie,
G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
[RESULTS OF 42 TERMINO-LATERAL PORTACAVAL ANASTOMOSES].
September 1963, Revue medico-chirurgicale des maladies du foie,
G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
[Clinical and hemodynamic evaluation of distal selective splenorenal anastomoses by the Warren method].
February 1980, Helvetica chirurgica acta,
G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
Prospective comparative clinical trial with distal splenorenal and mesocaval shunts.
January 1979, American journal of surgery,
G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
Selective distal splenorenal shunts. Technique and results.
August 1981, American journal of surgery,
G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
[Liver failure in patients with a latero-lateral portacaval anastomosis].
November 1981, Minerva chirurgica,
G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
[SELECTIVE RENAL PHLEBOGRAPHY AND SPLENORENAL ANASTOMOSES].
January 1964, Archives des maladies de l'appareil digestif et des maladies de la nutrition,
G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
Selective distal splenorenal shunt. Technique and results of operation.
March 1974, Archives of surgery (Chicago, Ill. : 1960),
G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
[RESULTS AFTER 2 YEARS OF 33 TERMINO-LATERAL PORTACAVAL ANASTOMOSES].
January 1964, Revue internationale d'hepatologie,
G Pezzuoli, and G P Spina, and F Galeotti, and E Opocher, and R Santambrogio, and G Gagliano, and M Strinna
Improved results with selective distal splenorenal shunt in a highly selected patient population. A prospective study.
August 1989, Annals of surgery,
Copied contents to your clipboard!