Comparison of the long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices

Background/Aims: This study was undertaken to evaluate the comparison of lo ng-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices. Methodology: Twenty-four cirrhotic patients underwent distal splenorenal sh unt, and 19 cirrhotic patients underwent esophageal transection with comple te variceal eradication and follow-up for at least 3 years. Results: No recurrent varix was observed in the distal splenorenal shunt gr oup. The cumulative recurrence rates of varices in the esophageal transecti on group were 31.6%, and 52.5% at 5 and 10 years, respectively. The cumulat ive rates of hyperammonemia at 5 and 10 years were significantly higher in the distal splenorenal shunt group (30.4%, 30.4%) than in the esophageal tr ansection group (0%, 5.6%) (P=0.009). The cumulative survival rates in the distal splenorenal shunt group versus the esophageal transection group were 90.9% versus 94.7%, and 85.2% versus 81.7% at 5 and 10 years (NS). Conclusions: These results suggest that distal splenorenal shunt is more ef fective than esophageal transection in preventing recurrence of esophageal varices, but is associated with a higher incidence of hyperammonemia.