Skip to main content

Surgical Therapies for Management

Surgical Shunts and Liver Transplantation

  • Chapter
Book cover Portal Hypertension

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Surgeons have played a role in the management of portal hypertension since Eck performed the first end-to-side portacaval shunt (the Eck fistula) in dogs at the end of the 19th century (1). Several surgeons in the early 1900s attempted to manage variceal bleeding with various procedures, but it was in the 1940s that there was the first systematic use of surgical shunts to control variceal bleeding by the Columbia Presbyterian Group in New York.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Donovan AJ, Covey PC. Early history of the portacaval shunt in humans. Surgery Gynecol Obstet 1978;147:423–430.

    CAS  Google Scholar 

  2. Henderson JM. Anatomy of the portal venous system in portal hypertension. In: Bircher, Benhamaou, McIntyre, Rizzetto, Rodes, eds. Oxford Textbook of Clinical Hepatology. Oxford Univ Press, U.K., 1999, pp. 645–651.

    Google Scholar 

  3. Orloff MJ, Orloff MS, Orloff SL, Rambotti M, Girard B. Three decades of experience with emergency portacaval shunt for acutely bleeding esophageal varices in 400 unselected patients with cirrhosis of the liver [see comments]. J Am Coll Surg 1995;180:257–272.

    PubMed  CAS  Google Scholar 

  4. Stipa S, Balducci G, Ziparo V, Stipa F, Lucandri G. Total shunting and elective management of variceal bleeding. World J Surg 1994;18:200–204.

    Article  PubMed  CAS  Google Scholar 

  5. Henderson JM, Warren WD, Millikan WJ Jr. et al. Surgical options, hematologic evaluation, and pathologic changes in Budd-Chiari syndrome. Am J Surg 1990;l 59:41–48; discussion 48–50.

    Article  Google Scholar 

  6. Sarfeh IJ, Rypins KB, Mason GR. A systematic appraisal of portacaval H-graft diameters. Clinical and hemodynamic perspectives. Ann Surg 1986;204:356–363.

    Article  PubMed  CAS  Google Scholar 

  7. Collins JC, Ong MJ, Rypins EB, Sarfeh IJ. Partial portacaval shunt for variceal hemorrhage: longitudinal analysis of effectiveness. Arch Surg 133(6):590–592.

    Google Scholar 

  8. Rosemurgy AS, Serofini FM, Zweibal BR, et al. TIPS versus small diameter prosthetic H-graft portacaval shunt: extended follow-up of an expanded randomized prospective trial. J Gastrointest Surg 2000;4:589–597.

    Article  PubMed  CAS  Google Scholar 

  9. Mercado MA, Orozco H, Guillen-Novarro E, et al. Small diameter mesocaval shunts: a 10 year evaluation. J Gastrointest Surg 2000;4:453–457.

    Article  PubMed  CAS  Google Scholar 

  10. Warren WD, Zeppa R, Fomon JJ. Selective trans-splenic decompression of gastroesophageal varices by distal splenorenal shunt. Ann Surg 1967;166:437–455.

    Article  PubMed  CAS  Google Scholar 

  11. Tnokuchi K. A selective portacaval shunt. Lancet 1968;2:51–52.

    Article  Google Scholar 

  12. Henderson JM. Role of distal splenorenal shunt for long-term management of variceal bleeding. World J Surg 1994;18:205–210.

    Article  PubMed  CAS  Google Scholar 

  13. Spina GP, Henderson JM, Rikkers LF, et al. Distal spleno-renal shunt versus endoscopic sclerotherapy in the prevention of variceal rebleeding. A meta-analysis of 4 randomized clinical trials. J Hepatol 1992;16:338–345.

    Article  PubMed  CAS  Google Scholar 

  14. Henderson JM, Nagle A, Curtas S, Geisinger MA, Barnes D. Surgical Shunts and TIPS for variceal decompression in the 1990’s. Surgery 2000;128:540–547.

    Article  PubMed  CAS  Google Scholar 

  15. Jenkins RL, Gedaly R, Pomposelli JJ, et al. Distal splenorenal shunt: role, indications, and utility in the era of liver transplantation. Arch Surg 1999;134:416–420.

    Article  PubMed  CAS  Google Scholar 

  16. Orozco H, Mercado MA, Garcia JG, et al. Selective shunts for portal hypertension current role of a 21 year experience. Liver Transplant Surg 1997;3:475–480.

    Article  CAS  Google Scholar 

  17. Rikkers LF, Jin G, Langnas AN, Shaw BW Jr. Shunt surgery during the era of liver transplantation. Ann Surg 1997;226:51–57.

    Article  PubMed  CAS  Google Scholar 

  18. Sugiura M, Futagawa S. Esophageal transection with paraesophagogastric devascularizations (the Sugiura procedure) in the treatment of esophageal varices. World J Surg 1984;8:673–679.

    Article  PubMed  CAS  Google Scholar 

  19. Idezuki Y, Kokudo N, Sanjo K, Bandai Y. Sugiura procedure for management of variceal bleeding in Japan. World J Surg 1994;18:216–221.

    Article  PubMed  CAS  Google Scholar 

  20. Orozco H, Mercado MA, Takahashi T, et al. Elective treatment of bleeding varices with the Sugiura operation over 10 years. Am J Surg 1992;163:585–589.

    Article  PubMed  CAS  Google Scholar 

  21. Dagenais M, Langer B, Taylor BR, Greig FD. Experience with radical esophagogastric devascularization procedures (Sugiura) for variceal bleeding outside Japan. World J Surg 1994;18:222–228.

    Article  PubMed  CAS  Google Scholar 

  22. Henderson JM. Liver transplantation for portal hypertension. Gastroenterol Clin North Am 1992;21:197.

    PubMed  CAS  Google Scholar 

  23. Bismuth H, Adam R, Mathur S, Sherlock D. Options for elective treatment of portal hypertension in cirrhotic patients in the transplantation era. Am J Surg 1990;160:105.

    Article  PubMed  CAS  Google Scholar 

  24. Ringe B, Lang H, Tusch G, Pichlmayr R. Role of liver transplantation in management of esophageal variceal hemorrhage. 1994;18:233.

    CAS  Google Scholar 

  25. Abu-Elmagd K, Iwatsuki S. Portal hypertension: role of liver transplantation. In: Cameron J, ed. Current Surgical Therapy: 7th ed. Mosby, St. Louis, 2001, pp. 406–413.

    Google Scholar 

  26. Roberts JP, Ring E, Lake JR, Sterneck M, Ascher NL. Intrahepatic portocaval shunt for variceal hemorrhage prior to liver transplantation. Transplantation 1991;52:160–162.

    Article  PubMed  CAS  Google Scholar 

  27. Mazzaferro V, Todo S, Tzakis AG, Stieber AC, Makowka L, Starzl TE. Liver transplantation in patients with previous portasystemic shunt. Am J Surg 1990;160:111–116.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Henderson, J.M. (2005). Surgical Therapies for Management. In: Sanyal, A.J., Shah, V.H. (eds) Portal Hypertension. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-59259-885-4_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-885-4_16

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-386-2

  • Online ISBN: 978-1-59259-885-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics