Summary
18 patients underwent CT-investigation with bolus injection of contrast medium 5 to 11 years after splenorenal Warren shunt. According to this investigation all patients were found to have developed hepatofugal collaterals in consequence of distal splenorenal anastomotic suction. In most cases the portal liver perfusion was maintained. These effects are not homogeneous and show variations from patient to patient.
Zusammenfassung
5-11 Jahre nach der Warren-Operation sind 18 Patienten einer CT-Untersuchung mit bolusmäßiger im. Injektion des Kontrastmittels unterzogen worden. Dabei konnte gezeigt werden, daß sich bei sämtlichen Fällen nach der Warrenschen Operation durch die Saugwirkung der distalen spleno-renalen Anastomose hepatofugale Kreisläufe entwickeln. Zu beobachten ist, daß in vielen Fällen gleichzeitig die portale Leberperfusion erhalten bleibt. Das Phänomen ist nicht uniform und zeigt Schwankungen von Fall zu Fall.
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Literatur
Belghiti J, Grenier P, Novel O, Nahum H, Fekete F (1981) Long-term loss of Warren's shunt selectivity. Arch Surg 116:1121–1124
Conn HO (1985) Ideal treatment of portal hypertension in 1985. Clin Gastroenterol 14:259–288
Fischer P, Köster O, Lackner K, Kunz R, Koischwitz D (1983) Computer-tomographische Befunde bei portaler Hypertension infolge Leberzirrhose. Teil 2: Discriminanz-analytische Ergebnisse. Fortschr Röntgenstr 139:77–81
Foley WD, Gleystee JJ, Lawson TL, Berland LL, Smith DF, Thorsen MK, Unger GF (1983) Dynamic computer tomography and pulsed Doppler ultrasonography in the evaluation of splenorenal shunt patency. J Comput Assist Tomogr 7:106–112
Gleysteen JJ, Foley WD, Lawson TL, Unger GF (1982) Patency evaluation of distal splenorenal shunt with dynamic computed tomography. Surg Gynecol Obstet 154:689–694
Goldberg BB, Patel J (1977) Ultrasonic evaluation of portocaval shunt. J Clin Ultrasound 5:304
Henderson JM, Millikan WJ, Warren DW (1984) The distal splenorenal shunt: an update. World J Surg 8:722–732
Langer B, Taylor R, Mackenzie R, Gilas T, Stone RM, Blendis L (1985) Further report of prospective randomized trial comparing distal splenorenal shunt with end-to-side portocaval shunt. Gastroenterology 88:424–429
Maillard JN, Flamant JM, Hay JM, Chandler JG (1979) Selectivity of the distal splenorenal shunt. Surgery 86:663–670
Marzoli GP, Vesentini S (1982) Warren's operation. Springer, Berlin Heidelberg New York
Smith JL, Graham DY (1982) Variceal hemorrhage. Gastroenterology 82:968–973
Subramanyam BR, Balthazar EJ, Madamba MR, Raghavendra BN, Horii SC, Lefleur RS (1983) Sonography of portosystemic venous collaterals in portal hypertension. Radiology 146:161–166
Voorhees AB, Price JB (1984) An update of portal systemic shunting and its complications. World J Surg 8:698–701
Warren WD, Millikan WJ, Henderson JM, Rasheed ME, Salam AA (1984) Selective variceal decompression after splenectomy or splenic vein thrombosis. Ann Surg 199:694–702
Wildrich WC, Robbins AH, Johnson WC, Nabseth DC (1980) Long-term follow-up of distal splenorenal shunt. Radiol Diagn 134:341–345
Zeppa R, Hudson DG, Levi JU, Livingstone AS (1984) Factors influencing survival after distal splenorenal shunt. World J Surg 8:733–737
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Marzoli, G.P., Gostner, P., Martin, F. et al. Der portale Kreislauf nach der Warrenschen Operation: Computertomographische Untersuchungen der portalen Hämodynamik 5–11 Jahre nach distaler spleno-renaler Anastomose. Langenbecks Arch Chiv 370, 185–196 (1987). https://doi.org/10.1007/BF01259538
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DOI: https://doi.org/10.1007/BF01259538