Moreno González E, Calle Santiuste A, García Blanch G, Landa García I, García García I
2nd Digestive Surgical Department, C.S. Primero de Octubre, University, Madrid, Spain.
Int Surg. 1987 Oct-Dec;72(4):197-200.
From 1976 to 1982, 104 patients with bleeding esophageal varices were treated surgically. In three patients a wide left gastric vein without portal flow was demonstrated by means of arterial splenoportography. Ascites estimated at between 4-to-6 liters was observed in two patients. Anemia, leukopenia and platelet counts below 85 X 10(9)/l were shown in all of three. Liver panangiography was performed on all three patients. Given the absence of portal flow, the presence of intractable ascites and the demonstration of a wide left gastric vein, we dissect this vein disconnecting it from the stomach, and performing the anastomosis between the proximal end of this vessel and the inferior vena cava (proximal unselective left gastric caval shunt). Ascites and esophageal varices disappeared in our three patients between one and three weeks after the operation. The shunts were patent between eight months to eight and a half years after the operation. All three patients are still living.
1976年至1982年期间，104例食管静脉曲张出血患者接受了手术治疗。通过动脉脾门静脉造影显示，3例患者存在一条无门静脉血流的粗大胃左静脉。2例患者出现了估计在4至6升之间的腹水。所有这3例患者均表现出贫血、白细胞减少和血小板计数低于85×10⁹/L。对所有3例患者均进行了肝脏血管造影。鉴于无门静脉血流、存在顽固性腹水以及显示有粗大胃左静脉，我们解剖该静脉，将其与胃分离，并在该血管近端与下腔静脉之间进行吻合（近端非选择性胃左腔静脉分流术）。我们的3例患者在术后1至3周内腹水和食管静脉曲张消失。分流在术后8个月至8年半之间保持通畅。所有3例患者仍存活。
