Hottenrott C, Hanisch E
Chirurgische Universitätsklinik Frankfurt.
Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1990:387-90.
The results of conservative medical (propranolol) and endoscopic therapy for bleeding esophageal varices show that the surgical shunt is indicated in both, acute and elective situations. The portocaval end-to-side-shunt should be preferred for hemodynamic reasons. However, special selection of patients is required to prevent postoperative liver failure. Linton, Drapanas and Warren shunts have a higher recurrence rate, but seem more appropriate for liver transplantation candidates. In our own series, preoperative diagnostic shunt-simulation by balloon-occlusion of the portal vein via an umbilical catheter has tremendously improved the results, even for child C-patients.
保守药物治疗（普萘洛尔）和内镜治疗食管静脉曲张出血的结果表明，在急性和择期情况下均需进行手术分流。出于血流动力学原因，应首选门腔静脉端侧分流术。然而，需要对患者进行特殊选择以预防术后肝功能衰竭。林顿、德拉帕纳斯和沃伦分流术的复发率较高，但似乎更适合肝移植候选者。在我们自己的系列研究中，通过经脐静脉导管用球囊阻断门静脉进行术前诊断性分流模拟，极大地改善了治疗效果，即使对于Child C级患者也是如此。
