远端脾肾分流术与食管横断术治疗食管静脉曲张的长期效果比较。

Comparison of the long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices.

作者信息

Tajiri T, Onda M, Yoshida H, Mamada Y, Taniai N, Yamashita K

机构信息

First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.

出版信息

Hepatogastroenterology. 2000 Nov-Dec;47(36):1619-21.

PMID:11149016

Abstract

BACKGROUND/AIMS: This study was undertaken to evaluate the comparison of long-term results of distal splenorenal shunt and esophageal transection for the treatment of esophageal varices.

METHODOLOGY

Twenty-four cirrhotic patients underwent distal splenorenal shunt, and 19 cirrhotic patients underwent esophageal transection with complete variceal eradication and follow-up for at least 3 years.

RESULTS

No recurrent varix was observed in the distal splenorenal shunt group. The cumulative recurrence rates of varices in the esophageal transection group were 31.6%, and 52.5% at 5 and 10 years, respectively. The cumulative rates of hyperammonemia at 5 and 10 years were significantly higher in the distal splenorenal shunt group (30.4%, 30.4%) than in the esophageal transection group (0%, 5.6%) (P = 0.009). The cumulative survival rates in the distal splenorenal shunt group versus the esophageal transection group were 90.9% versus 94.7%, and 85.2% versus 81.7% at 5 and 10 years (NS).

CONCLUSIONS

These results suggest that distal splenorenal shunt is more effective than esophageal transection in preventing recurrence of esophageal varices, but is associated with a higher incidence of hyperammonemia.

摘要

背景/目的：本研究旨在评估脾肾分流术与食管横断术治疗食管静脉曲张的长期效果比较。

方法

24例肝硬化患者接受了脾肾分流术，19例肝硬化患者接受了食管横断术以彻底消除静脉曲张，并进行了至少3年的随访。

结果

脾肾分流术组未观察到静脉曲张复发。食管横断术组静脉曲张的累积复发率在5年和10年时分别为31.6%和52.5%。脾肾分流术组5年和10年的高氨血症累积发生率（30.4%，30.4%）显著高于食管横断术组（0%，5.6%）（P = 0.009）。脾肾分流术组与食管横断术组的5年和10年累积生存率分别为90.9%对94.7%，以及85.2%对81.7%（无显著性差异）。