J.Jpn. Surg. Soc.. 79(8): 724-728, 1978

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Report on the annual meeting

(PN) -CONTROVERSY IN SURGERY SELECTIVE DISTAL SPRENORENAL SHUNT

Forty six cases was treated with a selective distal splenorenal shunts. Operative mortarity was 4/46. One patient had a early thrombosis. 5-year survival was 66.0% after the selective distal sprenorenal shunts.
As for rational of a selective distal sprenorenal shunt, it is very important to retain hepatopetal pancreatic venous flow at least to the extent that this exsist before operation. So we have to do the best to disconnect between the pancreatic vein and splenic vein. Moreover, portal flow seems to find the way to the low pressure area and it might be difficult to isolate the high pressure right side of the portal bed from the low pressure side created by shunt. So, I would emphasize that the basic procedure is an operation, not just a shunt. The Gastric devascularization is an important part of this operation.
Examination of population of white cell and platelets counts before and after surgery from the patients with hypersplenism, clerly shows that the distal sprenorenal shunts has a positive effect. Statistical analyses indicate significant improvement (P＜0.001).

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