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  • Title: Comparison of the long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices.
    Author: Tajiri T, Onda M, Yoshida H, Mamada Y, Taniai N, Yamashita K.
    Journal: Hepatogastroenterology; 2000; 47(36):1619-21. PubMed ID: 11149016.
    Abstract:
    BACKGROUND/AIMS: This study was undertaken to evaluate the comparison of long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices. METHODOLOGY: Twenty-four cirrhotic patients underwent distal splenorenal shunt, and 19 cirrhotic patients underwent esophageal transection with complete variceal eradication and follow-up for at least 3 years. RESULTS: No recurrent varix was observed in the distal splenorenal shunt group. The cumulative recurrence rates of varices in the esophageal transection group were 31.6%, and 52.5% at 5 and 10 years, respectively. The cumulative rates of hyperammonemia at 5 and 10 years were significantly higher in the distal splenorenal shunt group (30.4%, 30.4%) than in the esophageal transection group (0%, 5.6%) (P = 0.009). The cumulative survival rates in the distal splenorenal shunt group versus the esophageal transection group were 90.9% versus 94.7%, and 85.2% versus 81.7% at 5 and 10 years (NS). CONCLUSIONS: These results suggest that distal splenorenal shunt is more effective than esophageal transection in preventing recurrence of esophageal varices, but is associated with a higher incidence of hyperammonemia.
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