title: Comparison of the long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices.
abstract: OBJECTIVE
  This study was undertaken to evaluate the comparison of long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices.
  
  
  METHODS
  Twenty-four cirrhotic patients underwent distal splenorenal shunt, and 19 cirrhotic patients underwent esophageal transection with complete variceal eradication and follow-up for at least 3 years.
  
  
  RESULTS
  No recurrent varix was observed in the distal splenorenal shunt group. The cumulative recurrence rates of varices in the esophageal transection group were 31.6%, and 52.5% at 5 and 10 years, respectively. The cumulative rates of hyperammonemia at 5 and 10 years were significantly higher in the distal splenorenal shunt group (30.4%, 30.4%) than in the esophageal transection group (0%, 5.6%) (P = 0.009). The cumulative survival rates in the distal splenorenal shunt group versus the esophageal transection group were 90.9% versus 94.7%, and 85.2% versus 81.7% at 5 and 10 years (NS).
  
  
  CONCLUSIONS
  These results suggest that distal splenorenal shunt is more effective than esophageal transection in preventing recurrence of esophageal varices, but is associated with a higher incidence of hyperammonemia.
authors.affiliation: First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. tajirit@nms.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Tajiri
authors.forename: M
authors.initials: M
authors.lastname: Onda
authors.forename: H
authors.initials: H
authors.lastname: Yoshida
authors.forename: Y
authors.initials: Y
authors.lastname: Mamada
authors.forename: N
authors.initials: N
authors.lastname: Taniai
authors.forename: K
authors.initials: K
authors.lastname: Yamashita
mesh_terms: D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013164:Splenorenal Shunt, Surgical; D015996:Survival Rate; D016896:Treatment Outcome