title: A 10-year experience of shunt surgery for esophago-gastric varices in a single center in Japan.
abstract: OBJECTIVE
  We report 10 years' experience of shunt surgeries, and in particular Inokuchi shunt operation, at a single Japanese center.
  
  
  METHODS
  Subjects were 50 patients who underwent shunt surgery, including Inokuchi shunt, distal splenorenal shunt, H-graft shunt, and inferior mesenteric venous-left renal vein shunt from November 1997 to November 2007. These patients were divided into two groups, a selective shunt group and a non-selective shunt group.
  
  
  RESULTS
  Surgical duration was significantly longer in the selective group than in the non-selective group (p<0.0001). Blood loss was also significantly larger in the non-selective group (p=0.012). Pre-portal venous pressure did not change significantly after shunting in the selective shunt group. On the other hand, it decreased significantly from 378 +/- 39.7 mmH2O to 246 +/- 56.0 mmH2O (p<0.0001) in the non-selective group. The 2 and 5 year patency rates were 87% and 68%, respectively, in the selective shunt group, and 87% and 87% in the non-selective shunt group.
  
  
  CONCLUSIONS
  Our data on survival rate and shunt patency for Inokchi shunt are similar to those originally reported by Inokuchi in 1984. The consecutive experiences of shunt operation in a single center were important for the improvement of surgical skills, both of the individual surgeon and the team.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, Japan. kanishok@med.niigata-u.ac.jp
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Oya
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakatsuka
authors.forename: Takaoki
authors.initials: T
authors.lastname: Watanabe
authors.forename: Hidenaka
authors.initials: H
authors.lastname: Kokai
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000641:Ammonia / Q000097:blood; D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery; D007564:Japan; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D013164:Splenorenal Shunt, Surgical; D015996:Survival Rate
chemical_list: D000641:Ammonia