Mordechay I, Jofe B
Isr J Med Sci. 1983 Feb;19(2):142-5.
The purpose of this review is not to delineate guidelines for the selection of shunting vs. nonshunting procedures in cases of esophageal bleeding due to varices and portal hypertension. The final choice made by the surgeon who is confronted with this problem is often influenced by his personal preferences and outlook. Our own view, based on limited experience, suggests that where sclerotherapy is not available or has failed, and in cases where the surgeon has to deal with a poor-risk patient, nonshunting operations such as the McDermott or the Chaube type of devascularization are the easiest and least time-consuming to perform, and hence the most promising for low operative and postoperative mortality. This is especially so when a surgeon has to be satisfied with the best available in a community hospital.
本综述的目的并非为门静脉高压引起的食管静脉曲张出血病例中分流术与非分流术的选择划定指导方针。面对这一问题的外科医生所做出的最终选择往往受其个人偏好和观点的影响。基于有限的经验，我们自己的观点是，在无法进行硬化疗法或硬化疗法失败的情况下，以及外科医生必须应对高危患者的情况下，诸如麦克德莫特或乔贝类型的去血管化等非分流手术是最容易实施且耗时最少的，因此对于降低手术和术后死亡率最具前景。当外科医生必须满足于社区医院现有的最佳条件时，情况尤其如此。
