[Portacaval H-graft shunt as an alternative long-term treatment in gastrointestinal hemorrhage caused by esophagogastric varices].
From 1984 to 1991, 44 cirrhotic patients with gastrointestinal bleeding by esophagogastric varices (EGV) underwent emergency or elective calibrated portacaval shunt (CPS) with a prothesis of small diameter (8 and 10 mm) due to the impossibility of bleeding control by other conservative methods. In this series this procedure was found to be an effective alternative with acceptable operative mortality (20.4%), and a high rate of hepatic portal flow maintenance (72.2%) although a high incidence of postoperative hepatic encephalopathy (38.6%) of easy control was observed. The global probability of survival at 12 and 24 months was 74 and 64%, respectively. Survival at one and 2 years was significantly higher in patients of Child score A than those of score B (94 and 88% versus 73 and 56%). Patients of Child score C all died by the end of the first month thus suggesting that CPS should be performed in patients with good liver function (Child scores A and B).
de Diego
A
A
Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid.
Bañares
R
R
Asanza
C G
CG
García Sabrido
J L
JL
Polo
J R
JR
Cos
E
E
Clemente
G
G
D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000150:complications*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical / Q000379:methods / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors
La derivación portocava en H como tratamiento alternativo a largo plazo en la hemorragia digestiva por varices esofagogástricas.