The distal splenorenal shunt (DSRS) was compared with the side-to-side portacaval shunt (PCS) in 93 prospectively matched patients with portal hypertension. After 38 months mean follow-up the two shunts had a different incidence of acute encephalopathy (22% in PCS group and 33% in DSRS group) and chronic encephalopathy (35% in PCS group and 17% in DSRS group), but the difference was not statistically significant. However, the only cases of severe and disabling chronic encephalopathy arose after PCS (p = 0.049). Actuarial curves of chronic encephalopathy showed that the maximum rate of encephalopathy (18%) in the DSRS group was reached 27 months after shunt surgery, whereas this value was reached and passed in PCS group only 4 months after shunt. Chronic encephalopathy occurred for a total duration of 20.1 months after PCS and only 11.1 months afer DSRS (p = 0.003) and occupied 46.3% of the follow-p of PCS patients, as contrasted to 18.7% of the follow-up of DSRS patients (p = 0.0001). DSRS is associated with a lower global incidence of chronic HE without severe forms and provides a better quality of life than does a nonselective shunt.
Improved quality of life after distal splenorenal shunt. A prospective comparison with side-to-side portacaval shunt / G. Spina, R. Santambrogio, E. Opocher, F. Galeotti, G. Cucchiaro, M. Strinna, G. Pezzuoli. - In: ANNALS OF SURGERY. - ISSN 0003-4932. - 208:1(1988 Jul), pp. 104-9-109.
Titolo: | Improved quality of life after distal splenorenal shunt. A prospective comparison with side-to-side portacaval shunt |
Autori: | |
Parole Chiave: | Portacaval Shunt, Surgical; Hepatic Encephalopathy; Prospective Studies; Humans; Quality of Life; Middle Aged; Splenorenal Shunt, Surgical; Male; Female |
Settore Scientifico Disciplinare: | Settore MED/18 - Chirurgia Generale |
Data di pubblicazione: | lug-1988 |
Rivista: | |
URL: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1493578/pdf/annsurg00185-0122.pdf |
Tipologia: | Article (author) |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1097/00000658-198807000-00015 |
Appare nelle tipologie: | 01 - Articolo su periodico |
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