Hutson D G, Livingstone A, Levi J U, Zeppa R
Surg Gynecol Obstet. 1982 Jul;155(1):46-8.
Hepatic failure and upper gastrointestinal bleeding following a distal splenorenal shunt is distinctly unusual. Should either or both of these complications develop in the immediate or early postoperative period, adequate angiographic studies should be done without delay so as to identify accurately the status of the portal and splenic venous systems. If an unligated coronary vein is apparent, transhepatic clotting should be accomplished. The presence of other major collateral vessels between the portal and splenic circulations may require surgical ligation. The presence of thrombosis of the portal vein represents a more serious problem, with thrombectomy and arterialization of the portal vein offering the best chance for survival in a patient with a deteriorating condition.
远端脾肾分流术后发生肝功能衰竭和上消化道出血极为罕见。若在术后即刻或早期出现上述任一并发症或两者皆有，应立即进行充分的血管造影检查，以准确查明门静脉和脾静脉系统的状况。若发现未结扎的冠状静脉，应行经肝凝血治疗。门静脉和脾循环之间存在其他主要侧支血管时，可能需要进行手术结扎。门静脉血栓形成是一个更严重的问题，对于病情恶化的患者，门静脉血栓切除术和门静脉动脉化是生存的最佳机会。
