Distal splenorenal shunting for bleeding gastric varices
Article first published online: 7 DEC 2005
Copyright © 1994 British Journal of Surgery Society Ltd.
British Journal of Surgery
Volume 81, Issue 2, pages 241–244, February 1994
How to Cite
Thomas, P. G. and D'Cruz, A. J. (1994), Distal splenorenal shunting for bleeding gastric varices. Br J Surg, 81: 241–244. doi: 10.1002/bjs.1800810227
- Issue published online: 7 DEC 2005
- Article first published online: 7 DEC 2005
- Manuscript Accepted: 8 MAY 1993
In patients with bleeding gastric varices from causes other than splenic vein thrombosis, endoscopic sclerotherapy and ablative surgery have yielded poor results. Over a 3-year period starting in June 1989, a total of 30 distal splenorenal shunts were performed prospecdvely on 19 paediatric and 11 adult patients with bleeding gastric varices and good liver function. The mean(s.d.) age was 17(12) (range 6–50) years; there were 20 male and ten female patients of whom six had cirrhosis, four non-cirrhotic portal fibrosis and 20 portal vein thrombosis. Two patients died and two more had shunt thrombosis; all four were considered failures of treatment. Hypersplenism was present in 15 patients but reverted to normal in 13. In 26 patients the gastric varices disappeared. Concomitant oesophageal varices were present in 22 patients and showed marked regression, with no rebleeding over a mean(s.d.) follow-up of 21(10) (range 7–39) months. A distal splenorenal shunt was effective in controlling gastric variceal haemorrhage in 26 of 30 patients in whom liver function was well preserved.