title: [Small diameter porto-caval shunt in patients with bleeding from esophageal varices: a report of twenty cases].
abstract: BACKGROUND
  SDPCS (The small diameter portacaval shunt) published originally by Rypins and Sarfeh in Los Angeles in 1983 has recieved little attention in our comunity to control bleeding in patients with portal hypertention. The bleeding of esophageal varices represents the must frequent and dramatic complication caused by cirrhosis, with a 50% of mortality without treatment.
  
  
  BACKGROUND
  Comunicate the indications, thecnique and results with the Small Diameter Portocaval shunt.
  
  
  METHODS
  Prospective trial from April 1992 to November 1998. Twenty patients with bleeding esophageal varices, 6 female, 14 male, ages 31-72 years;
  
  
  BACKGROUND
  Alcoholic Cirrhosis 7 patients; Hepatitis B virus 4 patients, Criptogenic 4 patients, Child A; 13 patients, Child B; 5 patients and Child B-C 2 patients. Direct intraoperatory Inferior Vena Cava and portal pressures was obteined in all cases.14 grafs 10 mm and 6, 8 mm Polytetrafiuoroetehilene (PTFE) grafts were used .
  
  
  RESULTS
  Follow up 6 to 68 months; Mortality 5%, morbidity 5%, rebleeding 15%, graft trhombosis 10%, encephalopathy: Mild 5%, Moderated 5%, Severe 10%. Mean surgical time 4.28 h. Mean blood transfussion 1.4 units of red blood cells. The venous pressure pre and post grafting decreased significantly p < 0.01.
  
  
  CONCLUSIONS
  SDPCS is a easy to apply procedure and results are addecuate; it requires an specialized preoperatory ultrasound. The descensus in portal pressure after grafting and graf permeability was corroborated.
authors.affiliation: Servicio de Cirugía, Hospital Guadalupe de Puebla, Puebla, México. juanorea45@hotmail.com
authors.forename: Juan Gerardo
authors.initials: JG
authors.lastname: Orea Martínez
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Obregón García
authors.forename: Ana María
authors.initials: AM
authors.lastname: Pérez Vergara
authors.forename: Alberto
authors.initials: A
authors.lastname: Márquez Acosta
mesh_terms: D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical / Q000379:methods*; D016896:Treatment Outcome