title: Influence of splenorenal shunt on long-term outcomes in cirrhosis.
abstract: OBJECTIVE
  To examine the clinical effect of splenorenal shunt (SRS) on the long-term outcomes in patients with cirrhosis.
  
  
  METHODS
  The study consisted of 162 cirrhosis patients (male 85, female 77; 62.6 ± 11.7 years). The clinical findings and prognosis were examined with respect to portal hemodynamics including collateral vessel patterns, with or without the presence of SRS or short gastric vein (SGV). Median observation period was 30 months.
  
  
  RESULTS
  The incidence was 18.5% for SRS and 10.5% for SGV. Decompensated cirrhosis was significantly more frequent in patients with SRS (22/30) than those with SGV (5/17, p = 0.0034), and in patients with SRS >5.5 mm (14/15) or >95 ml/min (14/15) (both, median values) than those with SRS <5.5 mm (8/15, p = 0.013) or <95 ml/min (8/15, p = 0.013). Cumulative overall survival rate was 87.4% at 1 year, 73.4% at 3 years, and 59.1% at 5 years. There was no significant difference in the cumulative survival rate according to the development of SRS: 80% at 1 year, 66.6% at 3 years, and 58.3% at 5 years in patients with SRS; 94.1% at 1 year, 87.4% at 3 years, and 72.8% at 5 years in patients with SGV; 88.3% at 1 year, 73.1% at 3 years, and 58% at 5 years in patients without SGV/SRS; 94.1% at 1 year, 87.4% at 3 years, and 72.8% at 5 years in patients with SGV (overall, p = 0.2).
  
  
  CONCLUSIONS
  In spite of no significant effect on the prognosis in cirrhosis, careful management may be necessary for the patients with SRS because of potential poor liver function demonstrated by the close linkage between the presence of SRS and decompensation.
authors: Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine , Chiba , Japan.
authors: Hitoshi
authors: H
authors: Maruyama
authors: Takayuki
authors: T
authors: Kondo
authors: Soichiro
authors: S
authors: Kiyono
authors: Tadashi
authors: T
authors: Sekimoto
authors: Masanori
authors: M
authors: Takahashi
authors: Osamu
authors: O
authors: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003097:Collateral Circulation; D004932:Esophageal and Gastric Varices / Q000473:pathology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology*; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013162:Splenic Vein / Q000503:physiopathology; D013164:Splenorenal Shunt, Surgical; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: cirrhosis; portal hypertension; splenorenal shunt