Inferior mesenteric vein left renal vein shunt in portal hypertension | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 21, Issue 3, July 2002, Page 1014-1021 PDF (4.7 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2002.403222 | ||||
 View on SCiNiTO | ||||
| Author | ||||
| Magdy Haggag* | ||||
| Faculty of Medicine, Cairo niversity, Egypt | ||||
| Abstract | ||||
| No general consensus exists regardiug the proper surgical 111nnageme11t of recurrent variceal bleeding due to liver cirrl1osis.TI1e inherent small diameter of the iuferior mesenteric Vl!ill cau be used for shunting blood to systemic circulation, not diverting blood completely from the liver. The study included 24 patients, 7 females and 17 males with age range behueen 21to 45 years.All patients were class A and B accordi11g to Child classificatioll allfi had prior episode of variceal bleeding duo to portal hypertension. Preoperative liver functions, upper GI endoscopy for variceal grading, and presence of gastropatlly were compared wit/1 tl1e postoperative results. TI1e outcome of this shunt revealed no reb/eeding episodes, improveme11t of variceal gradings, no postoperative development of ascites or encephalopatl1y in all patients.There was improvement in liver functions and endoscopic degree of gastropathy. Ouly one patient developed portosystemic encllalopatlty after 18 monll1s of follow 11p. There was no improvement of blood picture and splenectomy had to be done in cases with hypersplenis m. [ar/y shunt patency rate was 19124 (70.5%) and 14 shunts were found patent after 18 mouths of follow up. In conclusion, Inferior mesenteric vein to left renal veiu shunt is a simple procecfure, witlr small stoma, durable shunt, effective in portal decompression, and can be used as a good altemtrtive to major shunt procedures or tra11s-intemal jugular portosystemic shunt (TIPS) before liver transplantation. | ||||
| Keywords | ||||
| Portal hypertension; Inferior IIIL'Senteric vein shunl; esophngealt>arices | ||||
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