[Shunt surgery in portal hypertension. Pathophysiology and indications].
Portosystemic shunts are well established methods of avoiding recurrent hemorrhage from esophageal varices. Hemodynamic aspects and clinical results suggest that distal splenorenal shunts should be preferred over non-selective shunts. The functional capacity of the liver is crucial for any type of shunt. In patients with Child C cirrhosis, mortality is known to be particularly high following an emergency shunt so that, this procedure is recommended only as a rescue operation. Although prophylactic shunting decreases the risk of bleeding from varices, it leads to higher liver-related mortality. Prophylactic shunts are, therefore, indicated only in exceptional cases.
Otto
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Chirurgische Universitätsklinik Heidelberg.
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D002404:Catheterization / Q000295:instrumentation*; D004932:Esophageal and Gastric Varices / Q000503:physiopathology / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000503:physiopathology / Q000601:surgery*; D006439:Hemodynamics / Q000502:physiology*; D006503:Hepatic Veins / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology / Q000601:surgery*; D007601:Jugular Veins; D011169:Portal Vein / Q000601:surgery; D011170:Portasystemic Shunt, Surgical / Q000295:instrumentation*; D012008:Recurrence; D015607:Stents
Shuntchirurgie bei portaler Hypertension. Pathophysiologie und Indikationsstellung.