Subtotal splenectomy and portal variceal disconnection in the treatment of portal hypertension. 1993

A Petroianu
Department of Surgery, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil.

Bleeding gastroesophageal varices caused by portal hypertension can be treated successfully by subtotal splenectomy and central splenorenal shunting. However, in elderly patients and those at high risk of hepatic failure, congestive heart failure and encephalopathy or when splenorenal anastomosis is impossible, an alternative is subtotal splenectomy and portal variceal disconnection. The author reports on the first nine patients who underwent this procedure and describes the operative technique. Complications of the operation were minimal. One patient had thrombocytosis, but this was controlled clinically. No patient experienced encephalopathy during a follow-up ranging from 10 months to 8 years. No rebleeding was noted in seven of the patients, but two had a bleeding duodenal ulcer, which was treated successfully. Liver function was preserved in all patients. These results have encouraged the author to continue investigation of subtotal splenectomy and portal variceal disconnection.

UI MeSH Term Description Entries
D006975 Hypertension, Portal Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN. Cruveilhier-Baumgarten Disease,Cruveilhier-Baumgarten Syndrome,Cruveilhier Baumgarten Disease,Cruveilhier Baumgarten Syndrome,Disease, Cruveilhier-Baumgarten,Portal Hypertension,Portal Hypertensions,Syndrome, Cruveilhier-Baumgarten
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
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
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012555 Schistosomiasis mansoni Schistosomiasis caused by Schistosoma mansoni. It is endemic in Africa, the Middle East, South America, and the Caribbean and affects mainly the bowel, spleen, and liver. Schistosomiasis, Intestinal,Schistosoma mansoni Infection,Infection, Schistosoma mansoni,Infections, Schistosoma mansoni,Intestinal Schistosomiases,Intestinal Schistosomiasis,Schistosoma mansoni Infections,Schistosomiases, Intestinal

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