Ma. Mercado et al., DISTAL SPLENORENAL SHUNT VERSUS 10-MM LOW DIAMETER MESOCAVAL SHUNT FOR VARICEAL HEMORRHAGE, The American journal of surgery, 171(6), 1996, pp. 591-595
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.