The effect of distal splenorenal shunt in treatment of portal hypertension / 中华普通外科杂志

ABSTRACT

Objective To evaluate the effect of distal splenorenal shunts (DSRS) in treatment of portal hypertension.Methods A retrospective analysis was made on 16 patients undergoing DSRS between 2009 and 2015 in a single institution.Perioperative free portal pressure (FPP),blood routine,liver function were collected and analyzed.Postoperative complications,long-term anastomotic status and the rate of re-bleeding were observed.Results Before and after DSRS,FPP were (43 ± 9) cmH2O and (31 ± 6) cmH2 O,a decrease of 29.1％ (t =7.326,P ＜ 0.01).Postoperative serum total bilirubin and peripheral blood leukocyte increased significantly (t =-3.462,t =-2.822,P ＜ 0.05).There was no significant difference in the changes of platelet and albumin before and after surgery.7 patients (7/16,43.8％) had one or more complications including 5 cases (31.3％) of portal vein thrombosis,massive ascites in 4 cases (25.0％),1 case (6.3％) of pulmonary infection and 1 case (6.3％) of wound infection.There was no inhospital mortality and all the 16 cases were followed up with no shunt anastomotic stenosis as showed by enhanced CT scan,meanwhile postoperative re-bleeding occurred in 1 case (6.3％) and 1 case (6.3％) died from liver failure.Conclusions Distal splenorenal shunts provides an effective method for the treatment of portal hypertension.