par Kestens, Paul 
;Lambilliotte, Jean-Pierre
Référence Acta gastro-enterologica Belgica (Ed. multilingue), 37, 9, page (383-401)
Publication Publié, 1974
;Lambilliotte, Jean-Pierre Référence Acta gastro-enterologica Belgica (Ed. multilingue), 37, 9, page (383-401)
Publication Publié, 1974
Article révisé par les pairs
| Résumé : | Though portal systemic shunt has become a routine procedure, the correct surgical management of portal hypertension in cirrhosis still presents a number of problems both as to the indications and the results. It is true that in general the established operations for portal systemic shunt produce regression of the esophageal varices and protect the patient from recurrent bleeding, but they provide only palliative therapy and in no way eliminate the actual cause of portal hypertension, i.e. the lesion of the liver parenchyma. On the contrary, the diminution of blood supply to the liver which these operations inevitably bring about through the complete or partial shunting of splanchnic vein blood impairs the regenerative capacity of the liver and thus accelerates the development of severe hepatic failure, terminating in postshunt encephalopathy, coma and death. This is the reason why new procedures and refinements of older techniques have been proposed in recent years with the object of reducing the adverse effects of the classic portal systemic shunt. The authors list the principal types of shunt currently performed. They set forth the advantages and drawbacks of the techniques and, in the light of recent advances, attempt to clarify the present trends of this type of surgery and to justify them. |
