A 10-Year Experience of Shunt Surgery for Esophago-Gastric Varices in a Single Center in Japan

作者：Sato Yoshinobu^*; Oya Hiroshi; Yamamoto Satoshi; Kobayashi Takashi; Nakatsuka Hideki; Watanabe Takaoki; Kokai Hidenaka; Hatakeyama Katsuyoshi

来源：Hepato-Gastroenterology, 2011, 58(106): 444-452.

• shunt surgery
• Inokuch's shunt
• distal splenorenal shunt
• esophageal transection
• Hassab'operation
• hepatic encephalopathy

Background/Aims: We report 10 years' experience of shunt surgeries, and in particular Inokuchi shunt operation, at a single Japanese center.
Methodology: Subjects were 50 patients who underwent shunt surgery, including Inokuchi shunt, distal splenorenal shunt, H-graft shunt, and inferior mesenteric venous-left renal vein shunt from November 1997 to November 2007. These patients were divided into two groups, a selective shunt group and a non-selective shunt group.
Results: Surgical duration was significantly longer in the selective group than in the non-selective group (p<0.0001). Blood loss was also significantly larger in the non-selective group (p=0.012). Pre-portal venous pressure did not change significantly after shunting in the selective shunt group. On the other hand, it decreased significantly from 378 +/- 39.7 mmH(2)0 to 246 +/- 56.0 mmH(2)O (p<0.0001) in the non-selective group. The 2 and 5 year patency rates were 87% and 68%, respectively, in the selective shunt group, and 87% and 87% in the non-selective shunt group.
Conclusions: Our data on survival rate and shunt patency for Inokchi shunt are similar to those originally reported by Inokuchi in 1984. The consecutive experiences of shunt operation in a single center were important for the improvement of surgical skills, both of the individual surgeon and the team.

• 出版日期2011-4