Warren W D, Whitehead J B
Jpn J Surg. 1986 Mar;16(2):77-83. doi: 10.1007/BF02471075.
A prospective randomized trial of selective distal splenorenal shunt (DSRS) versus H-graft interposition total shunt at Emory Hospital in 1971 showed DSRS to be superior to a total shunt in shunt patency, prevention of variceal bleeding, preserving hepatic cell function, preserving the quality of life and patient survival. These results were particularly evident in the non-alcoholic patients. In the alcoholic patients, there was a greater loss of hepatic portal perfusion. In a later phase of the study, it was found that pancreatic veins formed a pathway of collaterals to the shunt, that is a so-called pancreatic siphon. In order to prevent loss of portal and pancreatic flow through the siphon, a total spleno-pancreatic disconnection was developed, whereby the hormone diversion is expected to be diminished.
1971年在埃默里医院进行的一项关于选择性远端脾肾分流术（DSRS）与H型移植管置入全分流术的前瞻性随机试验表明，DSRS在分流通畅性、预防静脉曲张出血、保护肝细胞功能、维持生活质量和患者生存率方面优于全分流术。这些结果在非酒精性患者中尤为明显。在酒精性患者中，肝门静脉灌注损失更大。在研究的后期阶段，发现胰腺静脉形成了一条通向分流的侧支循环途径，即所谓的胰腺虹吸。为了防止通过虹吸导致门静脉和胰腺血流丧失，开发了一种全脾胰断流术，从而有望减少激素转移。
