Paquet K J, Schulz D, Janson R, Biersack H J, Koischwitz D
Leber Magen Darm. 1981 Dec;11(6):252-7.
54 patients with cirrhosis of the liver and relapsing esophageal bleeding received mesentericocaval dacron shunts between 1st January 1975 and 31st December 1979 and were followed up to the end of 1980. Patients were accepted for surgery under the following conditions: (1) liver function had to be compensated, (2) there had to be no signs and symptoms of hepatoportal encephalopathy, (3) there had to be no signs and symptoms of activity of cirrhosis of the liver, (4) liver volume had to be between 1 000 and 2 500 ml, (5) portal vein perfusion had to be 15-35%, (6) stenosis of liver arteries had to be excluded. Lethality during the hospital period and from hepatoportal encephalopathy was 7.4%, late lethality was 11%; this accounted for a 5-year survival rate of 70%. Residual perfusion of the portal vein could be demonstrated in many cases by intra- and postoperative measurements with different methods. The dacron prosthesis was implanted into the superior mesenteric vein in an acute angle (it had a diameter of 16 mm). The prosthesis was occluded by thrombosis in 3 out of the first 18 cases operated upon. This could be prevented in the following 36 patients by intra- and postoperative longterm heparinisation.
1975年1月1日至1979年12月31日期间，54例肝硬化并复发性食管出血患者接受了肠系膜上静脉-腔静脉涤纶分流术，并随访至1980年底。患者在以下条件下接受手术：（1）肝功能必须代偿；（2）必须无肝门静脉性脑病的体征和症状；（3）必须无肝硬化活动的体征和症状；（4）肝脏体积必须在1000至2500毫升之间；（5）门静脉灌注必须为15%至35%；（6）必须排除肝动脉狭窄。住院期间及肝门静脉性脑病导致的死亡率为7.4%，晚期死亡率为11%；这使得5年生存率为70%。在许多病例中，通过术前和术后采用不同方法测量可证实门静脉有残余灌注。涤纶假体以锐角植入肠系膜上静脉（其直径为16毫米）。在前18例手术病例中有3例假体因血栓形成而堵塞。在随后的36例患者中，通过术前和术后长期肝素化可预防这种情况。
