J.Jpn. Surg. Soc.. 79(8): 719-723, 1978

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Report on the annual meeting

(PN) CONTROVERSY IN SURGERY LEFT GASTRIC VENA CAVAL SHUNT
－ITS RATIONALE AND CLINICAL RESULTS OF 150 CASES－

Left gastric vena caval shunt has been applied to 150 patients with esophageal varices, including 113 with cirrhosis of the liver and 32 with idiopathic portal hypertension. Follow-up period ranged from 1 to 11 years averaging 6 years and 2 months.
The early death occurred in 4.0 percent, the survival rate being 74.7 percent and the postoperative bleeding rate 8.7 percent. Confined to the cirrhotic patients, the operative mortality was 5.3 percent and the survival rate 68.1 percent. The postoperative bleeding rate in the therapeutic and prophylactic series were 11.4 and 2.2 percent, respectively. The rehabilitation status of the 112 surviving patients has been satisfactory without any signs of hepatoencephalopathy. The shunt was proved to be patent in about 90 percent of the patients and a selective drainage from esophageal varices has been successfully established.
The theoretical basis of selective drainage of esophageal varices was clarified by the present clinical results as well as the rentogenologic and the hemodynamic studies which were routinely performed during surgery. The left gastric vena caval shunt is believed to have definit merits in surgical treatment of cirrhosis of the liver.

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