Selective Distal Splenorenal Shunt: Technique and Results of Operation

W. Dean Warren, Atef A. Salam, Duane Hutson, Robert Zeppa

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91 Scopus citations

Abstract

The selective distal splenorenal shunt has been evaluated from the standpoint of its effectiveness in control of gastrointestinal variceal hemorrhage in the cirrhotic and the metabolic changes induced by this procedure. It has been shown to be superior to total portosystemic shunting procedures in the metabolic aspects of the study and has a markedly lower incidence of encephalopathy as compared to previous data from our studies as well as those from numerous other investigators. The operative mortality has been progressively lowered and now has reached levels comparable to those experienced in the utilization of total portosystemic shunting procedures. It should be clearly recognized, however, that the presence of massive ascites is a contraindication to the use of the selective portosystemic shunt, as this can result in failure to control ascites and an unacceptably high mortality In this particular group of patients. It is our conclusion that, for the patient with cirrhosis of the liver who Is free of ascites but has had one major episode of hemorrhage from gastroesophageal varices, the selective distal splenorenal shunt offers the optimal method of management at the current time.

Original languageEnglish (US)
Pages (from-to)306-314
Number of pages9
JournalArchives of Surgery
Volume108
Issue number3
DOIs
StatePublished - Mar 1974

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ASJC Scopus subject areas

  • Surgery

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