Splenic artery ligation in distal splenorenal shunts
| Autor: | William J. Millikan, Bernard M. Nordlinger, J.Timothy Fulenwider, W. Dean Warren |
|---|---|
| Rok vydání: | 1978 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Portal venous pressure Splenectomy Splenic artery Renal Veins medicine.artery Hypertension Portal medicine Humans Splenic Infarction Radionuclide Imaging Ligation Portography business.industry Distal splenorenal shunt procedure Thrombosis General Medicine Middle Aged medicine.disease Surgery Liver Splenic vein Evaluation Studies as Topic Splenic Vein Splenic infarction Portal hypertension Female Radiology business Splenic Artery Spleen |
| Zdroj: | American journal of surgery. 136(5) |
| ISSN: | 0002-9610 |
| Popis: | Splenic artery ligation, a simple surgical procedure expected to decrease splenic flow and portal pressure in patients with cirrhosis of the liver, was performed concomitantly with a distal splenorenal shunt procedure in six patients and as the main surgical procedure in two patients. Immediate cessation of bleeding was achieved in the four patients in whom the splenic artery was ligated to reduce intraoperative bleeding. However, three of the seven patients with previous gastroesophageal hemorrhage rebled from various postoperatively. Symptoms of splenic infarction were observed in six patients, resulting in thrombosis of the splenic vein and/or of the distal splenorenal shunt in four patients and necessitating splenectomy in one. This incidence of thrombosis of the distal splenorenal shunt is much higher than the overall incidence of 5 per cent observed at our institution. It is thus concluded that the splenic artery should not be ligated in cirrhotic patients with patent distal splenorenal shunts, since splenic arterial collateral vessels have already been reduced by the gastric devascularization, an integral component of the distal splenorenal shunt. |
| Databáze: | OpenAIRE |
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