Effect of distal splenorenal shunt plus splenopancreatic disconnection on glucose and amino acid metabolism |
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Authors: | Hashimoto Naoki Ashida Hiroshi |
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Institution: | Department of Surgery, Kinki University School of Medicine, Osaka, Japan. Hashiline@aol.com |
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Abstract: | BACKGROUND/AIMS: The Warren-Zeppa distal selective splenorenal shunt (DSRS) is aimed at decompressing esophageal varices by a distal splenorenal shunt, at the same time ligaturing left gastric, gastroepiploic and umbilical veins. In the long-term follow-up the loss of shunt selectivity was observed in several cases. Therefore, Inokuti and Warren reported splenopancreatic disconnection (SPD) to prevent splenic collaterals from stealing portal venous blood. METHODOLOGY: This report presents metabolic data (K-glucose, IRI in iv-GTT, Fischer ratio) of 10 cirrhotic patients operated with DSRS plus SPD. RESULTS: K-glucose of iv-GTT was improved from 2.3 +/- 0.2 to 2.5 +/- 0.2. Fischer ratio was also improved from 1.58 to 2.0 after the operation. IRI behavior tends to be lower after operation as a result of devascularlization of the collateral circulation by the selective shunt. CONCLUSIONS: From these results it seems that DSRS+SPD has favorable effects on glucose and amino acid metabolism. |
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