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

Abstract

BACKGROUND/AIMS:

This study was undertaken to evaluate the comparison of long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices.

METHODOLOGY:

Twenty-four cirrhotic patients underwent distal splenorenal shunt, and 19 cirrhotic patients underwent esophageal transection with complete variceal eradication and follow-up for at least 3 years.

RESULTS:

No recurrent varix was observed in the distal splenorenal shunt group. The cumulative recurrence rates of varices in the esophageal transection group were 31.6%, and 52.5% at 5 and 10 years, respectively. The cumulative 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 transection 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 effective than esophageal transection in preventing recurrence of esophageal varices, but is associated with a higher incidence of hyperammonemia.

• Authors: T Tajiri, M Onda, H Yoshida, Y Mamada, N Taniai, K Yamashita
• Journal: Hepato-gastroenterology (Hepatogastroenterology) 2000 Nov-Dec Vol. 47 Issue 36 Pg. 1619-21 ISSN: 0172-6390 [Print] Greece
• PMID: 11149016 (Publication Type: Comparative Study, Journal Article)

Topics

• Esophageal and Gastric Varices (surgery)
• Female
• Humans
• Male
• Middle Aged
• Splenorenal Shunt, Surgical
• Survival Rate
• Treatment Outcome