Abstract
A prospective randomized trial of selective distal splenorenal shunt (DSRS)versus H-graft interposition total shunt at Emory Hospital in 1971 showed DSRS to be superior to a total shunt in shunt patency, prevention of variceal bleeding, preserving hepatic cell function, preserving the quality of life and patient survival. These results were particularly evident in the non-alcoholic patients. In the alcoholic patients, there was a greater loss of hepatic portal perfusion. In a later phase of the study, it was found that pancreatic veins formed a pathway of collaterals to the shunt, that is a socalled pancreatic siphon. In order to prevent loss of portal and pancreatic flow through the siphon, a total spleno-pancreatic disconnection was developed, whereby the hormone diversion is expected to be diminished.
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This report is the gist of a paper read by W. D. W. at the 85th Annual Meeting of the Japanese Surgical Society, Sendai, Japan, 1985
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Warren, W.D., Whitehead, J.B. Recent advances in the management of variceal bleeding. The Japanese Journal of Surgery 16, 77–83 (1986). https://doi.org/10.1007/BF02471075
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DOI: https://doi.org/10.1007/BF02471075