Peracchia A
Ateneo Parmense Acta Biomed. 1975 May-Jun;46(3):101-11.
The interposition mesocaval shunt is followed both by a splancnic and sinusoidal decompression, being for this reason considered not only the most effective peripheral porto-systemic shunt, but also one of the indicated operations in the treatment of intractable cyrrhotic ascites. Intractable cyrrhotic ascites was the main indication in 9 cases with very different clinical pictures treated by the Author with mesocaval shunt, having observed no operative mortality and resulting a complete disappearance of ascites in 8 out of 9 cases and of the cohexistent idrothorax in one case. Angiographic pictures showed the patency of the shunt with constant demonstration, after few months, of a reversal portal blood flow (sometimes present before operation). This shunting procedure proved to be a very well tolerated operation with only a transient postoperative modification of liver function tests, excepted for one case in which the patient was lost after seven months because of hepatic encephalopaty with progressive liver failure.
间置中腔静脉分流术可同时实现内脏和肝血窦减压,因此不仅被认为是最有效的外周门体分流术,也是治疗顽固性肝硬化腹水的推荐手术之一。作者对9例临床表现差异很大的患者采用中腔静脉分流术治疗,顽固性肝硬化腹水是主要适应证,术中无手术死亡病例,9例中有8例腹水完全消失,1例同时存在的胸腔积液也消失。血管造影显示分流管通畅,几个月后持续显示门静脉血流逆转(有时术前就已存在)。除1例患者术后7个月因肝性脑病伴进行性肝功能衰竭而失访外,该分流手术耐受性良好,术后肝功能检查仅出现短暂改变。