Controlled splenorenal shunt for esophageal varices with the long term clinical observations
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Late results of our newly devised controlled splenorenal shunt were mentioned. This procedure involves special technique which confirms patency of the shunt and controls the postshunt blood volume in order to maintain consistently considerable portal blood flows into the liver even after the shunt. Our clinical analysis on 40 cases included 12 of Laennec or septal cirrhosis of the liver (Nagayo B-type), 7 of postnecrotic cirrhosis (Nagayo A-type), 13 of intrahepatic presinusoidal portal hypertension and 8 of prehepatic obstruction and schistosomiasis japonica, and among these 24 elapsed longer than 3 years and 14 longer than 5 years after the operation. Operative mortality, rate of postoperative bleeding, 5-year survival rate ware 15%, 7.5% and 67.5% respectively in over all cases, and should A-type of cirrhosis were omitted from the statistics, the operative mortality was 3% and long term survival rate 82% respectively. Since A-type of liver cirrhosis is apt to fall into circulatory insufficiency of the liver even by the controlled shunting, it is considered not to be adopted as indication of this operation.
KeywordsPortal Hypertension Esophageal Varix Patency Rate Iliac Vein Portal Blood
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