title: Long-term results of small-diameter proximal splenorenal venous shunt: a retrospective study.
abstract: OBJECTIVE
  To investigate recurrent variceal hemorrhage and long-term survival rates of patients treated with partial proximal splenorenal venous shunt.
  
  
  METHODS
  Patients with variceal hemorrhage who were treated with small-diameter proximal splenorenal venous shunt in Ruijin Hospital between 1996 and 2009 were included in this study. Shunt diameter was determined before operation using Duplex Doppler ultrasonography. Peri-operative and long-term results in term of rehemorrhage, encephalopathy and mortality were followed up.
  
  
  RESULTS
  Ninety-eight patients with Child A and B variceal hemorrhage received small-diameter proximal splenorenal venous shunt with a diameter of 7-10 mm. After operation, the patients' mean free portal pressure (P < 0.01) and the flow rate of main portal vein (P < 0.01) decreased significantly compared with that before operation. The rates of rebleeding and mortality were 6.12% (6 cases) and 2.04% (2 cases), respectively. Ninety-one patients were followed up for 7 mo-14 years (median, 48.57 mo). Long-term rates of rehemorrhage and encephalopathy were 4.40% (4 cases) and 3.30% (3 cases), respectively. Thirteen patients (14.29%) died mainly due to progressive hepatic dysfunction. Five- and ten-year survival rates were 82.12% and 71.24%, respectively.
  
  
  CONCLUSIONS
  Small-diameter proximal splenorenal venous shunt affords protection against variceal rehemorrhage with a low occurrence of encephalopathy in patients with normal liver function.
authors.affiliation: Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Yang
authors.forename: Ji-Qi
authors.initials: JQ
authors.lastname: Yan
authors.forename: Qin-Yu
authors.initials: QY
authors.lastname: Li
authors.forename: Di
authors.initials: D
authors.lastname: Ma
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013164:Splenorenal Shunt, Surgical / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult