Berchtold R
Langenbecks Arch Chir. 1976 Nov 15;342:153-7. doi: 10.1007/BF01267362.
The fundamental principles of the distal splenorenal shunt are three-fold (1) selective decompression of gastroesophageal varices; (2) simulation of a spontaneous and sometimes effective gastro-spleno-suprarenal shunt; and (3) maintenance of the portal-venous perfusion of the liver. The cirrhotic patient with hemorrhagic episodes who is free of ascites and in whom angiography reveals either good or poor portal flow to the liver is a suitable subject for this procedure. The essential stages and difficulties of the surgical technique are discussed.
(1)选择性减压食管胃静脉曲张;(2)模拟自然且有时有效的胃-脾-肾上腺分流;(3)维持肝脏的门静脉灌注。没有腹水、血管造影显示肝脏门静脉血流良好或不佳的出血性发作的肝硬化患者是该手术的合适对象。文中讨论了手术技术的关键步骤和难点。