Open AccessPortacaval H-Graft
Author(s) -
I. James Sarfeh,
Eric B. Rypins,
Robert M. Conroy,
Gary L. Mason
Publication year - 1983
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-198304000-00008
Subject(s) - medicine , portacaval shunt , ligation , surgery , encephalopathy , shunt (medical) , portal hypertension , gastroenterology , cirrhosis
Small-diameter protacaval H-grafts, 10, 12, or 14 mm, were constructed in 29 cirrhotic patients with previous or active variceal hemorrhage. When 10 mm grafts were used in combination with portal collateral outflow ligation, varying degrees of prograde portal flow were maintained in 50% of the patients. When shunt size was greater, prograde flow was lost in more than 90%. The incidence of spontaneous postoperative encephalopathy was 11% in patients with prograde flow, compared with 50% in those with retrograde flow (p = 0.05). It is concluded that maintaining prograde portal flow after portacaval shunt is essential in minimizing postoperative encephalopathy. Prograde portal flow may be achieved in 50% of patients using 10 mm PTFE portacaval H-grafts combined with portal collateral ligation.