Retrospective studies on shunt patency after porto systemic shunts in portal hypertensive patiens with bleeding oesophageal varices

Abstract

We studied 105 cases of portal hypertension bleeding varices, eighty-six males and nineteen females with a mean age of 44 years old. All patients were either Child class- A orB; they were divided into three groups, GroupA (44cases)=Distal splenorenal DSR.S. Group B (20 cases) =Inferior mesorenal shunt = H-splenorenal shunt. Group C (41 cases) =Small diameter partial portocaval shunt (Sarfeh). All patients were complaining of hematemsis, most of them were complaining of melena (86.6%) and 47.6% had a documented history of sclerotherapy. All patients were examined clinically, 59% had shrunken liver, 41% had hepatomegally and 99% of patient had splenomegally. All patient were examined endoscopically, esophageal varices were graded to: grade I: 11.4%, grade II: 29.5%, grade III: 35.2% and grade IV: 23.8%. By Child's Classification patients were classified to: Class A 65.7% and Class B 34.3%.

Studying of portal hemodynamics m preoperative, early and late postoperative periods reported that: Portal vein diameter was significantly decreased in-group A, B and C. Also portal vein flow was significantly decreased in-group A, B and insignificantly decreased in-group C. Also portal vein velocity was significantly decreased in group A, B and insignificantly increased in group C. Splenic vein diameter was