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KMID : 0371319890370040449
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Journal of the Korean Surgical Society
1989 Volume.37 No. 4 p.449 ~ p.458
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Results of Warren Shunt for Esophageal Variceal Bleeding
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Yoo Hwan-Young
Kim Sang-Jun
Lee Kuhn-Uk
Kim Soo-Tae
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Abstract
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Clinical analysis of 27 patients undergone distal spleonorenal shunt due to esophageal variceal bleeding was done. Male to female ratio of the patients was 16:11 and distribution of the patients was similar for each age range with the average age of 39.2. The Child classes were A in 9 cases (33.3%), B in 12 cases (44.5%) and C in 6 cases (22.2%) and the underlying liver diseases were liver cirrhosis in 21 cases (77.8%), which was most prevalent, idipathic portal hypertension in 3 cases, venous thrombosis in 2 cases, and septal fibrosis in 1 case, respectively. The operative mortality was 7.4%. Major post-operative complications were transient hyperbilirubinemia (40.7%), ascites (25.9%) and rebleeding (25.9%), and postshunt encephalopathy (3.7%). As hyperilirubinemia and ascites were managed successfully without specific treatment or only with conservative management, they did not matter. However, in the cases of rebleeding, as 4 cases out of 7 rebled patients eventually underwent reoperation, more studies to prevent and treat that complication should be done. As there was only one case of post-shunt encephalopathy, distal splenorenal shunt for bleeding esophageal varices which required operation could improve the quality of life.
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KEYWORD
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Distal splenorenal shunt, Encepholopathy, Esophageal varix
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