title: Effect of distal splenorenal shunt plus splenopancreatic disconnection on glucose and amino acid metabolism.
abstract: OBJECTIVE
  The Warren-Zeppa distal selective splenorenal shunt (DSRS) is aimed at decompressing esophageal varices by a distal splenorenal shunt, at the same time ligaturing left gastric, gastroepiploic and umbilical veins. In the long-term follow-up the loss of shunt selectivity was observed in several cases. Therefore, Inokuti and Warren reported splenopancreatic disconnection (SPD) to prevent splenic collaterals from stealing portal venous blood.
  
  
  METHODS
  This report presents metabolic data (K-glucose, IRI in iv-GTT, Fischer ratio) of 10 cirrhotic patients operated with DSRS plus SPD.
  
  
  RESULTS
  K-glucose of iv-GTT was improved from 2.3 +/- 0.2 to 2.5 +/- 0.2. Fischer ratio was also improved from 1.58 to 2.0 after the operation. IRI behavior tends to be lower after operation as a result of devascularlization of the collateral circulation by the selective shunt.
  
  
  CONCLUSIONS
  From these results it seems that DSRS+SPD has favorable effects on glucose and amino acid metabolism.
authors.affiliation: Department of Surgery, Kinki University School of Medicine, Osaka, Japan. Hashiline@aol.com
authors.forename: Naoki
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ashida
mesh_terms: D000596:Amino Acids / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism*; D004932:Esophageal and Gastric Varices / Q000097:blood* / Q000150:complications / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000097:blood* / Q000209:etiology / Q000601:surgery; D005951:Glucose Tolerance Test; D006801:Humans; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D013154:Spleen / Q000601:surgery*; D013164:Splenorenal Shunt, Surgical
chemical_list: D000596:Amino Acids; D001786:Blood Glucose