Distal splenorenal shunt: the experience at the Puerto Rico University Hospital
Cruz, N.I.; Márquez, E.
Boletin de la Asociacion Medica de Puerto Rico 73(7): 335-340
1981
ISSN/ISBN: 0004-4849 PMID: 6946790 Document Number: 701033
The experience at the Puerto Rico University Hospital with the distal splenorenal shunt in the period between 1974 and 1980 is reviewed. A total of 47 shunts were performed in the six year period, but follow up information was available for retrospective evaluation in only 40 patients. The group had 26 males and 21 females with an average age of 32 years. Sixty percent of the group had portal hypertension secondary to schistosomiasis. The average amount of bleeding episodes from esophageal varices was three per patient prior to surgery. Most of the patients (83 percent) were Child's "A" classification. The operative mortality was 4 percent. Ascites occurred in 43 percent of the patients, but this was on little clinical significance, since they have all responded well to diuretics. Recurrent bleeding has been documented in 5 percent of the group. Shunt potency as established by angiographic studies has been 93 percent. None of the patients have developed encephalopathy, which has been one of the great improvements obtained with the selective shunting procedure as compared with the total shunts such as the portacaval with its accepted 30 percent incidence of encephalopathy. We feel this operation, performed at our institution, has an acceptable mortality and will offer the patient a better quality of life free from the constant threat of variceal bleeding and without the risk of encephalopathy.
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