Smith M, Tuft R J, Davidson A R, Laws J W, Dawson J L, Williams R
Br Med J. 1974 Sep 21;3(5933):705-8. doi: 10.1136/bmj.3.5933.705.
A series of 24 patients with cirrhosis have undergone mesentericocaval shunt operations for the relief of portal hypertension. Overall the results have been satisfactory. Four of the five patients treated as an emergency and 17 of the 19 who had the operation two to six weeks after haemorrhage had been controlled left hospital alive and well. Separation of the patients into three categories according to the findings of clinical and biochemical tests, however, showed that subsequent survival was satisfactory for patients in categories A and B but that all four patients in category C had died within one year after surgery. Assessment at three months showed that in three patients moderate hepatic encephalopathy had developed.Evidence that the shunt remains patent was shown by a low incidence of repeated gastrointestinal haemorrhage and a marked diminution in variceal size in 18 of the 19 cases examined serially. Radiographic techniques for confirming shunt patency were compared and cannulation of the graft via the femoral vein was found to provide a reliable and rapid means of assessment.
24例肝硬化患者接受了肠系膜上静脉-腔静脉分流术以缓解门静脉高压。总体结果令人满意。5例急诊手术患者中有4例，以及19例在出血后2至6周接受手术且出血已得到控制的患者中有17例，均存活且康复出院。然而，根据临床和生化检查结果将患者分为三类后发现，A类和B类患者术后存活情况良好，但C类的所有4例患者均在术后一年内死亡。术后三个月评估显示，有3例患者出现了中度肝性脑病。连续检查的19例病例中有18例反复胃肠道出血发生率低且静脉曲张大小明显减小，表明分流仍通畅。对用于确认分流通畅的放射学技术进行了比较，发现经股静脉插管至移植物可提供可靠且快速的评估方法。
