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Revista do Colégio Brasileiro de Cirurgiões

Print version ISSN 0100-6991On-line version ISSN 1809-4546


MELO, Valdinaldo Aragão de; MELO, Gustavo Barreto de  and  CENEVIVA, Reginaldo. Evaluation of distal splenorenal shunt, with and without splenic artery ligation,for the treatment of schistosomal portal hypertension. Rev. Col. Bras. Cir. [online]. 2003, vol.30, n.6, pp.460-463. ISSN 1809-4546.

BACKGROUND: A prospective study was developed throughout two years of observation to assess the results of distal splenorenal shunt (DSRS) associated with splenic artery ligation (SAL) in patients with schistosomal portal hypertension and history of gastroesophageal varices bleeding. METHODS: Thirty patients were divided into two groups: fifteen were submited to DSRS (Group I) and the other 15 were submited to DSRS associated with SAL (Group II). They were observed through 24 months of follow-up. In this period, it was assessed: recurrence of gastrointestinal bleeding, variceal endoscopic control and anastomosis patency at ultrasound and angiography. RESULTS: One patient from Group I (6.67%) developed thrombosis of the shunt and hemorrhage recurrence due to varices. In Group II, none of the patients, throughout 2 years of observation, disclosed anastomosis thrombosis and gastrointestinal bleeding. There was no statistically significant difference between the groups. Concerning with the endoscopic analysis six months after surgery, there was decrease in the size or disappearance of varices in 80% of patients from Group I and in 93% of those from Group II. CONCLUSIONS: Distal splenorenal shunt with splenic artery ligation is not associated with a higher incidence of thrombosis of the anastomosis, hemorrhage recurrence and did not change gastroesophageal variceal size in comparison to distal splenorenal shunt isolated.

Keywords : Splenorenal shunt, surgical; Hypertension, portal; Schistosomiasis; Thrombosis; Hemorrhage; Recurrence; Splenic artery.

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