The significance of portal vein thrombosis after distal splenorenal shunt
G. L. Jin and L. F. Rikkers
Department of Surgery, University of Nebraska Medical Center, Omaha 68198-3280.
The aims of this study were to determine the incidence of portal vein
thrombosis after the distal splenorenal shunt, to identify any predictive
factors, and to assess the clinical significance of this complication.
Preoperative and postoperative angiograms and clinical evaluation were
reviewed in 124 patients who underwent distal splenorenal shunts. Total and
partial portal vein thrombosis were seen on 13 (10.5%) and 22 (17.7%)
postoperative angiograms, respectively. The only preoperative variable
correlating with development of portal vein thrombosis was portal venous
perfusion, which was significantly lower in patients with than in those
without portal vein thrombosis. In six of 10 patients with postoperative
pancreatitis, portal vein thrombosis developed. The frequency of early
postoperative complications was significantly greater in patients with
total portal vein thrombosis than in those with partial or no thrombosis.
Long-term follow-up has shown no significant effects of portal vein
thrombosis on late ascites, encephalopathy, or survival.
