DISTAL SPLENORENAL SHUNT VERSUS 10-MM LOW DIAMETER MESOCAVAL SHUNT FOR VARICEAL HEMORRHAGE

BACKGROUND: Portal hypertension surgery remains a good therapeutic cho ice for well selected patients with variceal bleeding. The distal sple norenal shunt (DSRS) has shown good longterm results and low-diameter shunts have emerged as an alternate choice. METHODS: A prospective, co ntrolled and not randomized study was designed to compare the DSRS (23 patients) and the low-diameter 10 mm ring reinforced PTFE mesocaval s hunt (LDMCS) (22 patients) in low-risk electively operated patients (C hild-Pugh A-B). The operation was selected according to the anatomical status of the veins. RESULTS: Both groups were comparable. No differe nces were observed regarding rebleeding, operative mortality and survi val. Significative differences were observed regarding encephalopathy and shunt thrombosis (higher in the LDMCS). Postoperative angiography showed better maintenance of portal blood flow in the DSRS group. CONC LUSIONS: Both operations are adequate alternatives for the elective tr eatment of portal hypertension in low-risk patients. However, the DSRS has more advantages than the LDMCS.