05212022Sat
Last updateWed, 09 Mar 2022 4am

Selective surgical shunts for treating complications of portal hypertension: 10-year experience in a single institution in eastern Taiwan

Yen-Cheng Chena, †, Guan-Jin Hoa, †, Ying-Chin Yanga, Ming-Che Leea, b

a Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
b Department of Surgery, Tzu Chi University, Hualien, Taiwan

Full-Text HTML Download PDF


Abstract
Objective

Surgical portosystemic shunts are safe and effective for treating rebleeding gastric varices (GV) in portal hypertensive patients with well-preserved liver function. The aim of this study is to investigate the clinical outcomes of using selected surgical shunts for managing rebleeding GV at a single institution in eastern Taiwan.

Materials and Methods

We retrospectively recruited 12 patients who received distal splenorenal shunts (DSRS) following the indication of rebleeding GV or hypersplenism from January 2001 through December 2010. Their demographic data, etiology of portal hypertension, associated treatments, perioperative complications and clinical outcomes were reviewed.

Results

All patients received DSRS, including 10 adults and two children, and were examined for a median follow-up period of 53 months. No postoperative encephalopathy, major complications, or surgical mortality occurred. Two of the patients were waiting for liver transplants. Late rebleeding in esophageal varices developed in two patients who were successfully managed using endoscopic treatment. The etiology of portal hypertension had no significant impact on the postoperative complications.

Conclusion

Although there were a limited number of cases in this series, our results indicate that the DSRS is an effective treatment for rebleeding GV, especially for patients with well-preserved liver function and taking into account the realities of organ shortages.

Keywords
Distal splenorenal shunt; Gastric varices; Portal hypertension; Rebleeding


 

On the Cover

Search all Issue