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

Research output: Contribution to journalArticlepeer-review

Abstract

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 after DSRS (p = 0.003) and occupied 46.3% of the follow-up 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.

Original languageEnglish (US)
Pages (from-to)104-109
Number of pages6
JournalAnnals of surgery
Volume208
Issue number1
DOIs
StatePublished - 1988
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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