Spontaneous portacaval shunts in patients with gastric cancer and hepatic cirrhosis.
Two rare cases of a spontaneous portacaval shunt occurring in patients with gastric cancer and hepatic cirrhosis are retrospectively reviewed with special attention for the operative indications and techniques. One patient underwent proximal gastrectomy for a IIa cancer in the C region with splenectomy and closure of the splenorenal shunt, and died two years and 3 months later due to hepatic failure. The other patient underwent distal gastrectomy for IIa + IIc, IIc double cancers in the M and A regions with splenectomy through an upper transverse abdominal incision that ligated and divided the paraumbilico-caval shunt, and is alive and well 1 year and 2 months, postoperatively. The ICG-R15 was markedly decreased and the K-ICG and ICG-Rmax were improved following the operation in both cases. The preoperative chronic encephalopathy and hyperammonemia disappeared postoperatively in both cases.
Takeda
J
J
Department of Surgery, Kurume University School of Medicine.
Hashimoto
K
K
Tanaka
T
T
Koufuji
K
K
Kakegawa
T
T
Arishima
T
T
D005402:Fistula / Q000150:complications* / Q000601:surgery; D005743:Gastrectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications* / Q000601:surgery; D014682:Vena Cava, Inferior