Selective distal splenorenal shunts. Technique and results

Area of Science:

• Gastroenterology
• Hepatology
• Surgical Procedures

Background:

• Gastroesophageal varices are a common complication of portal hypertension.
• Gastrointestinal hemorrhage from these varices poses a significant risk to patients.
• Hepatic schistosomiasis is a notable cause of portal hypertension in certain regions.

Purpose of the Study:

• To evaluate the efficacy and safety of selective distal splenorenal shunt (SDSRS) in managing gastrointestinal hemorrhage.
• To assess the outcomes of SDSRS in patients with portal hypertension, particularly those with hepatic schistosomiasis.

Main Methods:

• A cohort of 20 patients with gastrointestinal hemorrhage from gastroesophageal varices underwent SDSRS.
• Diagnosis was confirmed via barium swallow roentgenography and esophagogastroscopy.
• Hepatic schistosomiasis was diagnosed through rectal biopsy and stool examination.

Main Results:

• The SDSRS procedure was successfully performed in all 20 patients.
• Gastrointestinal hemorrhage was the primary indication for surgery.
• Sixteen patients had portal hypertension secondary to hepatic schistosomiasis.
• A subset of patients also presented with ascites and jaundice.
• No cases of hepatic encephalopathy were reported during the follow-up period.

Conclusions:

• Selective distal splenorenal shunt is an effective surgical option for controlling gastrointestinal bleeding in patients with portal hypertension.
• The procedure appears to be safe, with no observed instances of hepatic encephalopathy in this cohort.
• SDSRS is a viable treatment for patients with variceal bleeding, including those with underlying hepatic schistosomiasis.