PMID: 3767488Nov 1, 1986Paper

Distal splenorenal shunt for management of variceal bleeding in patients with schistosomal hepatic fibrosis

Annals of Surgery
F A EzzatM H Kutner

Abstract

The distal splenorenal shunt was performed in 60 patients with schistosomal hepatic fibrosis in whom no evidence of cirrhosis was documented by preoperative needle and operative wedge biopsy. No patients have been lost to follow-up with a median of 37 months (range: 17-86). The results showed low operative mortality (1.7%), high patency rate (92.5%), and low recurrent variceal hemorrhage (6.7%). Thrombosed shunts were treated either by refashioning the shunt (1 patient) or splenectomy and gastric devascularization (2 patients). Initial hyperbilirubinemia and reduction in serum albumin were found in the early postoperative period, with persistent hyperbilirubinemia in 32% of the patients. The 5-year survival was 88%, with liver disease related mortality in only three patients. Clinical encephalopathy was detected in three patients (5.1%); only one of them was incapacitated. These data showed that: selective shunt (distal splenorenal shunt, DSRS) is an effective surgical procedure in the treatment of schistosomal variceal bleeding, shunt thrombosis is rare and can possible be corrected if detected early, schistosomal patients have a better survival and a lower incidence of encephalopathy after DSRS than that reported in cirrhotic...Continue Reading

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Citations

Mar 1, 1991·World Journal of Surgery·S RaiaF Alfieri Júnior
Sep 1, 1996·Journal of Clinical Gastroenterology·Q Q ContractorY R Kher
Jul 21, 2010·World Journal of Surgery·Fabio Ferrari MakdissiLuiz Augusto Carneiro D'Albuquerque
Jun 29, 2014·The Journal of Surgical Research·Guang-Quan ZongRen-Min Liu
Jan 1, 1989·Baillière's Clinical Gastroenterology·A K Burroughs, P A McCormick
May 1, 1991·World Journal of Surgery·K M Abu-ElmagdN G el-Hak
Apr 26, 2005·Journal of the American College of Surgeons·Adeyemi O LaosebikanNamasha M Naidoo
Jul 1, 1990·American Journal of Surgery·J A Myburgh
Jul 1, 1990·American Journal of Surgery·A A SalamK M Abu-Elmagd
Jun 10, 2004·World Journal of Gastroenterology : WJG·Roberto de ClevaJoaquim-José Gama-Rodrigues
Aug 1, 1994·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·H O Conn
Feb 1, 1994·The British Journal of Surgery·Y M YassinM el-Mirghani
Dec 4, 2014·World Journal of Gastroenterology : WJG·Renata Potonyacz ColaneriPaulo Herman
Sep 24, 2016·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Renata P ColaneriPaulo Herman

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