[Late results of portacaval surgical shunt in patients with extrahepatic portal hypertension].
Late outcomes of portocaval shunting (PCS) were analyzed in 135 patients with extrahepatic portal hypertension (EPH). It was established that the methods of choice in such patients should be splenorenal anastomosis, mesentericocaval anastomosis (MCA) "side by side" and H-type with autovenous or synthetic insertions. The best results were detected in a combination of portocaval anastomosis with the suturing pf stomach and esophageal varicose veins, if the diameter of the anastomosed vessel was small and portal pressure was reduced by less than 25% (100 mm of water column). The ineffectiveness of MCA "end in side" by Bogoras and cavamesenterial anastomosis was shown due to low efficiency and severe complications, respectively. These data demonstrate efficacy of endovascular dilatation in PCA stenoses, yet the possibilities of severe complications still exist. The best result of endoscopic PCS estimation 1 year after the surgery suggested complete recovery of patients with EPH in most cases.
Eramishantsev
A K
AK
Russian Research Center of Surgery, Russian Academy of Medical Sciences, Moscow.
Lebezev
V M
VM
Gunzynov
G D
GD
D000293:Adolescent; D000328:Adult; D002648:Child; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery*; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical / Q000379:methods; D017082:Portal Pressure; D012082:Renal Veins / Q000601:surgery; D013162:Splenic Vein / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome