Distal splenocaval shunt for rebleeding patients after periesophagastric devascularization / 中华普通外科杂志

ABSTRACT

Objective To evaluate the therapeutic effect of distal splenocaval shunt for portal hypertensive variceal rebleeding after periesophagastric devascularization.Method In this study 18 patients with recurrent bleeding after devascularization underwent distal splenocaval shunt.Clinical data and follow-up result were collected and analyzed.Result The free portal pressure decreased from (35.6 ±3.8) cm H2O before shunting to (26.9 ±2.7) cm H2O after shunting.The operative mortality was 0.Liver function after postoperative second day changed significantly comparing to preoperative levels and it recovered to pre-operative level after 7 days.The rate of rebleeding and ascites was 17％ and 44％ respectively.There were 2 patients suffering from postshunt hepatic encephalopathy and the 2-year survival rate was 94.4％.Conclusions Distal splenocaval shunt could still be performed in portal hypertensive patients with recurrent variceal bleeding after periesophagastric devascularization with a patent splenic vein.