Rypins E B, Mason G R, Conroy R M, Sarfeh I J
Ann Surg. 1984 Dec;200(6):706-10. doi: 10.1097/00000658-198412000-00006.
Patients undergoing small-diameter (8, 10, 12, and 14 mm) portacaval H-grafts were followed up to 3.5 years. Eight- and 10-mm grafts maintained prograde portal perfusion in 50% of the patients. Follow-up studies performed from 6 to 36 months after surgery show late shunt patency to be 97%. Recurrent variceal hemorrhage has not occurred in any patients. Direction of portal flow after a shunt was related to the size of the portal vein and the size of the shunt. If the shunt diameter was less than 50% that of the portal vein measured on the preoperative angiogram, portal flow was prograde. Encephalopathy rates remained significantly lower in patients with prograde flow after small diameter (8 and 10 mm) portacaval H-graft (p = .0.1). If thrombosis and encephalopathy rates remain low, the small-diameter, polytetrafluoroethylene portacaval H-graft is an attractive alternative to standard portacaval and mesocaval shunts.
对接受小直径（8、10、12和14毫米）门腔静脉H型分流术的患者进行了长达3.5年的随访。8毫米和10毫米的分流管在50%的患者中维持了门静脉正向血流灌注。术后6至36个月进行的随访研究显示，分流管后期通畅率为97%。所有患者均未发生复发性静脉曲张出血。分流后门静脉血流方向与门静脉大小和分流管大小有关。如果分流管直径小于术前血管造影测量的门静脉直径的50%，门静脉血流为正向。在接受小直径（8毫米和10毫米）门腔静脉H型分流术且血流正向的患者中，脑病发生率仍显著较低（p = 0.1）。如果血栓形成和脑病发生率保持较低水平，小直径聚四氟乙烯门腔静脉H型分流管是标准门腔静脉分流术和肠系膜上腔静脉分流术的一个有吸引力的替代方案。
