{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:05:50Z","timestamp":1760954750845},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[1989,1,1]],"date-time":"1989-01-01T00:00:00Z","timestamp":599616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1989,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>From June, 1969 to February, 1987, distal splenorenal shunt was carried out on 78 patients with esophagogastric varices. The operations were urgent in 9, elective in 40, and prophylactic in 29 patients. There were 52\u00a0males and 26 females. Age ranged from 16 to 76 years with an average of 53 years. Thirty\u2010seven patients were alcoholics. Hepatitis B surface antigen was positive in only 15.5%. The causes of portal hypertension were cirrhosis of the liver in 67, chronic hepatitis in 5, idiopathic portal hypertension in 4, primary biliary cirrhosis in 1, and fatty liver in 1 patient. Fifty\u2010two patients were in Child's class A, 18\u00a0in class B, and 8\u00a0in class C. Emergency shunts were performed only when conservative therapy had failed to stop variceal bleeding. Prophylactic operations were done in patients having Child's class A or class B liver disease and risky varices, in varices larger than 5\u00a0mm in diameter and\/or varices with red color signs such as cherry red spots. Forty\u2010two patients underwent the original Warren shunt, but the remaining 36 had modified distal splenorenal shunt with expanded polytetrafluoroethylene interposition. The operative mortality rates were 11.1% in the emergency group, 2.5% in the elective group, and 3.4% in the prophylactic group. The overall operative and hospital death rates were 3.8% and 7.7%, respectively. The patency rate was 94.1% and the incidence of rebleeding from esophageal varices was 3.8%. Hepatic encephalopathy, although mild to moderate in degree, was observed in 14.7% of 75 patients excluding 3 operative deaths. The 1\u2010, 2\u2010, and 3\u2010year survival rates of the emergency group were all 77.8%. The 1\u2010, 2\u2010, 3\u2010, 5\u2010, and 10\u2010year survival rates of the elective patients were 86.9%, 75.1%, 71.3%, 55.2%, and 29.4%, respectively. The 5\u2010, 10\u2010, and 15\u2010year survival rates of the prophylactic group were all 85.5%. The long\u2010term prognosis was significantly worse in patients in Child's class C and alcoholics as compared with otherwise<\/jats:bold>.<\/jats:p><jats:p><jats:bold>In the light of this retrospective evaluation, it can be concluded that distal splenorenal shunt is a reliable operative method in the treatment of esophagogastric varices associated with portal hypertension and that it can be performed safely in emergency, elective, and prophylactic situations<\/jats:bold>.<\/jats:p>","DOI":"10.1007\/bf01671163","type":"journal-article","created":{"date-parts":[[2005,5,9]],"date-time":"2005-05-09T09:27:33Z","timestamp":1115630853000},"page":"92-99","source":"Crossref","is-referenced-by-count":11,"title":["Appraisal of distal splenorenal shunt in the treatment of esophageal varices: An analysis of prophylactic, emergency, and elective shunts"],"prefix":"10.1002","volume":"13","author":[{"given":"Naofumi","family":"Nagasue","sequence":"first","affiliation":[{"name":"Second Department of Surgery Shimane Medical University 693 Izumo Japan"},{"name":"Department of Surgery Hiroshima Red Cross and Atomic Bomb Hospital Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Kohno","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Shimane Medical University 693 Izumo Japan"},{"name":"Department of Surgery Hiroshima Red Cross and Atomic Bomb Hospital Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Shimane Medical University 693 Izumo Japan"},{"name":"Department of Surgery Hiroshima Red Cross and Atomic Bomb Hospital Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Yukaya","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Shimane Medical University 693 Izumo Japan"},{"name":"Department of Surgery Hiroshima Red Cross and Atomic Bomb Hospital Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuichiro","family":"Tamada","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Shimane Medical University 693 Izumo Japan"},{"name":"Department of Surgery Hiroshima Red Cross and Atomic Bomb Hospital Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiharu","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Shimane Medical University 693 Izumo Japan"},{"name":"Department of Surgery Hiroshima Red Cross and Atomic Bomb Hospital Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Chung","family":"Chang","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Shimane Medical University 693 Izumo Japan"},{"name":"Department of Surgery Hiroshima Red Cross and Atomic Bomb Hospital Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teruhisa","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Second Department of Surgery Shimane Medical University 693 Izumo Japan"},{"name":"Department of Surgery Hiroshima Red Cross and Atomic Bomb Hospital Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1989,1]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(68)90127-X"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-70-4-675"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-197201000-00002"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196709000-00012"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198009000-00008"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1970.tb04048.x"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197103000-00007"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197809000-00002"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(79)90243-5"},{"key":"e_1_2_1_11_1","first-page":"45","article-title":"A prospective randomized trial of the selective distal splenorenal shunt","volume":"150","author":"Langer B.","year":"1980","journal-title":"Surg. 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