Distal Splenorenal Anastomosis in Patients of Different Age Groups
https://doi.org/10.16931/1995-5464.2015124-28
Abstract
Aim. To evaluate the results of distal splenorenal shunts (DSRS) in elderly patients with liver cirrhosis. Material and Methods. 285 patients of three age groups with liver cirrhosis (LC) and portal hypertension were enrolled: up to 30 years, 31–49 years and over 50 years. Selective portosystemic shunting was performed in all cases. Results. The study showed that there was no significantly greater risk of specific postoperative complications in patients
over 50 years if indications for bypass surgery were observed. The incidence of moderate and severe liver failure was 7.6% and 13.6% in patients aged up to 50 years and over 50 years respectively. Latent and clinical forms of hepatic encephalopathy were found in 57.1% and 66.7% of cases respectively. Incidence of ascites augmentation differed slightly – 14.1% versus 13.6%. Bleeding from esophageal varices in early postoperative period after DSRS developed in 5.7% of patients aged up to 50 years and in 4.5% of patients aged over 50 years. Conclusion. At present time DSRS is dominant surgery and performed in more than 50% of cases. In elderly patients or due to low compensatory reserve of hepatocytes this type of bypass surgery remains priority and sometimes unique way for portal system decompression
About the Authors
F. G. Nazyrov
Academician V. Vakhidov Republican Specialized Surgery Center
Russian Federation
Russian Federation
Doct. of Med. Sci., Professor, Director of academician V. Vakhidov Republican Specialized Surgery Center
A. V. Devyatov
Academician V. Vakhidov Republican Specialized Surgery Center
Russian Federation
Russian Federation
Doct. of Med. Sci., Professor, Principal Research Fellow of the Department of Portal Hypertension and Pancreatoduodenal Area Surgery of academician V. Vakhidov Republican Specialized Surgery Center
A. Kh. Babadzhanov
Academician V. Vakhidov Republican Specialized Surgery Center
Russian Federation
Russian Federation
Cand. of Med. Sci., Senior Research Fellow of the Department of Portal Hypertension and Pancreatoduodenal Area Surgery of academician V. Vakhidov Republican Specialized Surgery Center
S. A. Raimov
Academician V. Vakhidov Republican Specialized Surgery Center
Russian Federation
Russian Federation
Resident of the Department of Portal Hypertension and Pancreatoduodenal Area Surgery of academician V. Vakhidov Republican Specialized Surgery Center.
References
1. Hashimoto N., Ashida H. Effect of distal splenorenal shunt plus splenopancreatic disconnection on glucose and amino acid metabolism. Hepatogastroenterology. 2005; 5 (61): 274–276. PMID: 15783048
2. Kato K., Kondo S., Hirano S., Omi M., Ambo Y., Okushiba S., Katoh H. Surgical closure of the gastrorenal shunt with distal splenorenal shunt operation for portosystemic encephalopathy. Hepatogastroenterology. 2001; 48 (39): 840–841. PMID: 11462936
3. Livingstone A.S., Koniaris L.G., Perez E.A., Alvarez N., Levi J.U., Hutson D.G. 507 Warren Zeppa distal splenorenal shunts: a 34-year experience. Ann. Surg. 2006; 243 (6): 884–892. PMID: 16772792
4. Zubarev P.N., Kotiv B.N., Khokhlov A.V., Alent’yev S.A., Chalyj A.N. Choice of method of porto-caval shunting. Annaly khirurgicheskoy gepatologii. 2000; 5 (2): 227–228. (In Russian)
5. Mirzaev B.B. Vozmojnosti endoskopicheskih vmeshatel’stv na etapah khirurgicheskoy korrekcii portal’noy gipertenzii [Possibilities of endoscopic interventions at the stages of surgical correction of portal hypertension: dis. ... cand. med. sci.]. Tashkent, 2008. 150 p. (In Russian)
6. Nazyrov F.G., Akilov Kh.A., Devyatov A.V. Current condition of reconstructive surgery of portal blood circulation in patients with liver cirrhosis and the threat of variceal bleedings. Annaly khirurgicheskoy gepatologii. 2000; 5 (2): 245–246. (In Russian)
7. Shchyogolev A.A., Al’-Sabunchi O.A., Shepot’ko E.G. Prognoz krovotecheniya iz varikoznih ven pishevoda. Aktual’nie problemy sovremennoy khirurgii: trudi Mejdunarodnogo khirurgicheskogo kongressa [Prognosis of bleeding from esophageal varices. Actual problems of current surgery: proceedings of the International Surgical Congress.] Moscow, 2003. P. 18. (In Russian)
8. Turakulov A.B. Khirurgicheskie aspekti sindroma splenomegalii u boln’nih cirrozom pecheni [Surgical aspects of splenomegaly syndrome in patients with liver cirrhosis: dis. ... cand. med. sci.]. Tashkent, 2006. 126 p. (In Russian)
9. Khodzhiev D.Sh. Selektivnoe portosistemnoe shuntirovanie v khirurgii portal’noy gipertenzii u bolnih cirrozom pecheni [Selective porto-systemic shunting in portal hypertension surgery in patients with liver cirrhosis: autoref. dis. ... cand. med. sci.]. Tashkent: NCKh, 2000. 77 p. (In Russian)
Review
For citations:
Nazyrov F.G., Devyatov A.V., Babadzhanov A.Kh., Raimov S.A. Distal Splenorenal Anastomosis in Patients of Different Age Groups. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2015;20(1):24-28. (In Russ.) https://doi.org/10.16931/1995-5464.2015124-28
Views:
3277
Email this article 