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Die distale spleno-renale termino-laterale Anastomose nach Warren

The distal spleno-renal anastomosis of Warren

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Summary

This is a report on 28 Warren-Shunts, 17 of these patients had undergone clinical, hematological and angiographic controls 2–46 (mean 10) months after the operation. The critical evaluation of the results shows that the Warren derivation, which is selective at the moment of operation, develops in the following time some hepatofugal circulation. This is a more radical effect than the intended drainage of the gastro-esophageal venous bed alone.

Zusammenfassung

Verff. berichten über 28 distale termino-laterale splenorenale Shunts nach Warren. 17 dieser Patienten sind klinischen, hämatologischen und angiographischen Kontrollen, im Durchschnitt 10 (2–46) Monate nach der Operation, unterzogen worden. Die kritische Betrachtung der gewonnenen Ergebnisse läßt den Schluß zu, daß die Warrensche Derivation, obwohl zum Zeitpunkt der Operation tatsächlich selektiv, mit der Zeit zu einem gewissen hepatofugalen Kreislauf führt, dessen Wirksamkeit das primäre Vorhaben einer gezielten Drainage des gastro-oesophagealen Bettes allein übersteigt.

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Literatur

  1. Balz, J., Minton, J. P.: Mesenteric thrombosis following splenectomy. Ann. Surg.181, 126–128 (1975)

    PubMed  Google Scholar 

  2. Bengmark, S.: Surgical management of portal hypertension. Clin. Gastroenterol.4, 395–423 (1975)

    PubMed  Google Scholar 

  3. Berchtold, R.: Selektive Eingriffe bei der portalen Hypertension. Chirurg47, 266–270 (1976)

    PubMed  Google Scholar 

  4. Burchell, A. R., Moreno, A. H., Panke, W. F., Nealon, T. F.: Hemodynamics variables and prognosis following portacaval shunts. Surg. Gynecol. Obstet.138, 359–369 (1974)

    PubMed  Google Scholar 

  5. Charters, A. C., Brown, B. N., Sviolka, S. C., Knox, D. G., Orloff, M. J.: The influence of portal perfusion on the response to portacaval shunt. Am. J. Surg.130, 226–232 (1975)

    PubMed  Google Scholar 

  6. Child C. G. (ed.): Major problems in clinical surgery. Vol. 14: Portal hypertension. London: Saunders 1974

    Google Scholar 

  7. Dagnini, P.: Laparoscopia in ipertensione portale. Padova: Piccin 1978

    Google Scholar 

  8. Eßer, G.: Portale Shuntoperationen. Chirurg46, 400–405 (1975)

    PubMed  Google Scholar 

  9. Galambos, J. T., Rudman, D., Warren, W. D.: Portal hypertension: A new beginning for an old problem. Am. J. Dig. Dis.21, 827–832 (1976)

    PubMed  Google Scholar 

  10. Giltgemann, A., Eßer, G., Cerny, J., Schulz, D.: Klinische Erfahrungen zu Pfortaderhochdruck. Bruns Beitr. Klin. Chir.218, 97–108 (1970)

    PubMed  Google Scholar 

  11. Hutson, D. G., Pereiras, R., Zeppa, R., Levi, J. U., Schiff, E. R., Fink, P.: The fate of esophageal varices following selective distal splenorenal shunt. Ann. Surg.183, 496–501 (1976)

    PubMed  Google Scholar 

  12. Hutson, D. G., Zeppa, R., Levi, J. U., Schiff, E. R., Livingstone, A. S., Fink, P.: The effect of the distal splenorenal shunt on hypersplenism. Ann. Surg.185, 605–612 (1977)

    PubMed  Google Scholar 

  13. Jackson, F. C., Perrin, E. B., Dagradi, A. E., Smith, A. G.: Clinical investigation of the portacaval shunt. Arch. Surg.91, 43–54 (1965)

    Google Scholar 

  14. Kessler, R. E., Tice, D. A., Zimmon, D. S.: Retrograde flow of portal vein blood in patients with cirrhosis. Radiology92, 1038–1042 (1969)

    PubMed  Google Scholar 

  15. Leger, L., Lenriot, J. P., Duclos, J. M., Lemaigre, G.: Bilan de 187 dérivations porto-caves tronuclaires. Analyse statistique des facteurs prognostiques. I. Vue d'ensembles des opéres et résultats globaux. J. Chir.108, 31–46 (1974)

    Google Scholar 

  16. Loup, P., Mosimann, R.: Repercussions spléniques du shunt splénorénal distal selon Warren. Helv. Chir. Acta44, 477–480 (1977)

    PubMed  Google Scholar 

  17. Moreno, A. H., Burchell, A. R., Reddy, R. V., Steen, J. A., Panke, W. F., Nealon, T. F.: Spontaneous reversal of portal blood flow. Ann. Surg.181, 346–358 (1975)

    PubMed  Google Scholar 

  18. Nabseth, D. C., Widrich, W. C., O'Hara, E. T., Johnson, W. C.: Flow and pressure characteristics of the portal system before and after splenorenal shunts. Surgery78, 739–748 (1975)

    PubMed  Google Scholar 

  19. Paumgartner, G.: Die hämodynamische Abklärung der portalen Hypertonie. In: Chronische Hepatitis-Zirrhosen. Hrsg.: Wannagat, L. 7. Lebertagung der Sozialmediziner, Bad Mergentheim, 15.–17. Oktober 1974. Stuttgart: Thieme 1974

    Google Scholar 

  20. Pezzuoli, G., Spina, G. P.: La terapia di elezione della ipertensione portale. Atti Soc. Ital. Chir.1, 71 (1974)

    Google Scholar 

  21. Reichle, F. A.: Portal hemodynamics after distal (Warren) splenorenal shunts. Ann. Surg.176, 195–198 (1972)

    PubMed  Google Scholar 

  22. Reynolds, T. B.: The role of hemodynamic measurements in portosystemic shunt surgery. Arch. Surg.108, 276–281 (1974)

    PubMed  Google Scholar 

  23. Schröder, R., Preisig, R., Fuchs, W., Berchtold, R.: Angiographische und hämodynamische Studien vor und nach distaler splenorenaler Shuntoperation. Schweiz. Med. Wochenschr.106, 318–321 (1976)

    Google Scholar 

  24. Siegel, J. H., Goldwyn, R. M.: Hyperdynamic states and the physiologic determinants of survival. Arch. Surg.108, 282–292 (1974)

    PubMed  Google Scholar 

  25. Smith, G. W.: Use of hemodynamic selection criteria in the management of cirrhotic patients with portal hypertension. Ann. Surg.179, 782–790 (1974)

    PubMed  Google Scholar 

  26. Sovak, M., Soulen, R. L., Reichle, F. A.: Blood flow in the human portal vein. Radiology99, 531–536 (1971)

    PubMed  Google Scholar 

  27. Strandell, T., Delin, A., Erwald, R., Kulling, K. G., Lundbergh, P., Marions, O., Wiechel, K. L.: Portal blood flow measurement by a catheter tip electromagnetic velocity probe in awake man. Acta Chir. Scand.139, 7–10 (1973)

    PubMed  Google Scholar 

  28. Thomford, N. R., Sirinek, K. R., Martin, E. W.: A series of 20 successful Warren shunts. Arch. Surg.110, 584–587 (1975)

    PubMed  Google Scholar 

  29. Tylen, U., Simert, G., Vang, J.: Hemodynamic changes after distal splenorenal shunt, studied by sequential angiography. Radiology121, 585–589 (1976)

    PubMed  Google Scholar 

  30. Vang, J., Simert, G., Hansson, J. A., Tylen, U., Bengmark, S.: Results of a modified distal splenorenal shunt for portal hypertension. Ann. Surg.185, 224–228 (1977)

    PubMed  Google Scholar 

  31. Viamonte, M., Warren, W. D., Fomon, J., Martinez, L. O.: Angiographic investigations in portal hypertension. Surg. Gynecol. Obstet.130, 37–53 (1970)

    PubMed  Google Scholar 

  32. Warren, W. D., Fomon, J., Viamonte, M., Zeppa, R.: Preoperative assessment of portal hypertension. Ann. Surg.165, 999–1012 (1967)

    PubMed  Google Scholar 

  33. Warren, W. D., Salam, A. A., Hutson, D., Zeppa, R.: Selective distal splenorenal shunt. Arch. Surg.108, 306–314 (1974)

    PubMed  Google Scholar 

  34. Widrich, W. C., Robbins, A. H., Nabseth, D. C., O'Hara, E. T., Johnson, W. C., Loughlin, K. V.: Portal hypertension changes following selective splenorenal surgery. Radiology121, 295–302 (1976)

    PubMed  Google Scholar 

  35. Zeppa, R., Hutson, D., Bergstresser, P. R., Levi, J. U., Schiff, E. R., Fink, P.: Survival after distal splenorenal shunt. Surg. Gynecol. Obstet.145, 12–16 (1977)

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Chirurgische Klinik und Röntgeninstitut der Universität Padua mit Sitz in Verona, I-37100, Verona, Germany

    G. P. Marzoli, S. Vesentini, F. Frasson, C. Fugazzola & G. Mangiante

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  1. G. P. Marzoli
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  2. S. Vesentini
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  3. F. Frasson
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  4. C. Fugazzola
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  5. G. Mangiante
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Marzoli, G.P., Vesentini, S., Frasson, F. et al. Die distale spleno-renale termino-laterale Anastomose nach Warren. Langenbecks Arch Chiv 348, 93–103 (1979). https://doi.org/10.1007/BF01239666

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  • DOI: https://doi.org/10.1007/BF01239666

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