Open AccessSelective Variceal Decompression After Splenectomy or Splenic Vein Thrombosis
Author(s) -
Warren Wd,
William J. Millikan,
J. Michael Henderson,
Mustafa Rasheed,
Atef A. Salam
Publication year - 1984
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 - 10.1097/00000658-198406000-00007
Subject(s) - medicine , splenectomy , portal hypertension , splenic vein , surgery , splenic artery , thrombosis , portal vein thrombosis , shunt (medical) , portal venous pressure , angiography , decompression , portacaval shunt , radiology , cirrhosis , spleen
Eight patients have had selective variceal decompression after a splenectomy or splenic vein thrombosis with successful control of bleeding. The principle veins utilized in these patients, either alone or in combination, were: (a) the splenic remnant, (b) the coronary, (c) the gastroepiploic, and (d) an inferior mesenteric that joined the splenic. High quality preoperative angiography is essential but operative exploration is often required to assess fully the possible shunt options. Simple splenectomy for thrombocytopenia in portal hypertension is rarely justifiable and creates far more problems than it solves. Complete splenopancreatic disconnection extends the selective shunt concept.