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The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present

Based on an experience of more than 50 years in the treatment of portal hypertension (PHT), the authors review and analyze the evolution of the surgical portocaval shunt (PCS). We would like to provide an insight into the past of PCS, in order to compare it with the current state of the treatment of...

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Autores principales: Radu, Petre, Prunoiu, Virgiliu-Mihail, Strâmbu, Victor, Garofil, Dragos, Doncu, Roxana Elena, Brătucu, Eugen, Simion, Laurentiu, Răvaş, Maria-Manuela, Brătucu, Mircea Nicolae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509272/
https://www.ncbi.nlm.nih.gov/pubmed/36164663
http://dx.doi.org/10.1155/2022/1382556
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author Radu, Petre
Prunoiu, Virgiliu-Mihail
Strâmbu, Victor
Garofil, Dragos
Doncu, Roxana Elena
Brătucu, Eugen
Simion, Laurentiu
Răvaş, Maria-Manuela
Brătucu, Mircea Nicolae
author_facet Radu, Petre
Prunoiu, Virgiliu-Mihail
Strâmbu, Victor
Garofil, Dragos
Doncu, Roxana Elena
Brătucu, Eugen
Simion, Laurentiu
Răvaş, Maria-Manuela
Brătucu, Mircea Nicolae
author_sort Radu, Petre
collection PubMed
description Based on an experience of more than 50 years in the treatment of portal hypertension (PHT), the authors review and analyze the evolution of the surgical portocaval shunt (PCS). We would like to provide an insight into the past of PCS, in order to compare it with the current state of the treatment of PHT complications. As a landmark of the past, we shall present statistics of more than 500 cases of PHT operated between 1968 and 1983. From this group, 238 patients underwent surgical portocaval shunting during a fifteen-year period. The behavior of the portal hemodynamics following PCS was studied and the postoperative decrease in portal pressure (PP), as well as the residual PP, were recorded. The portal manometric determinations were made by electronic recordings using the Hellige device and direct intraoperative recordings through the catheterization of a ramus in the portal area. The results of PCS are superposable, in terms of hemodynamic efficiency, with those of the intrahepatic shunt (TIPS—transjugular intrahepatic portosystemic shunt). The authors discuss the current place of PCS, in obvious decline in comparison with the situation 50 years ago. The current methods of controlling variceal bleeding represent obvious progress. PCS remains with very limited indications, in specific situations when the other therapeutic methods have failed or are not recommended.
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spelling pubmed-95092722022-09-25 The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present Radu, Petre Prunoiu, Virgiliu-Mihail Strâmbu, Victor Garofil, Dragos Doncu, Roxana Elena Brătucu, Eugen Simion, Laurentiu Răvaş, Maria-Manuela Brătucu, Mircea Nicolae Can J Gastroenterol Hepatol Review Article Based on an experience of more than 50 years in the treatment of portal hypertension (PHT), the authors review and analyze the evolution of the surgical portocaval shunt (PCS). We would like to provide an insight into the past of PCS, in order to compare it with the current state of the treatment of PHT complications. As a landmark of the past, we shall present statistics of more than 500 cases of PHT operated between 1968 and 1983. From this group, 238 patients underwent surgical portocaval shunting during a fifteen-year period. The behavior of the portal hemodynamics following PCS was studied and the postoperative decrease in portal pressure (PP), as well as the residual PP, were recorded. The portal manometric determinations were made by electronic recordings using the Hellige device and direct intraoperative recordings through the catheterization of a ramus in the portal area. The results of PCS are superposable, in terms of hemodynamic efficiency, with those of the intrahepatic shunt (TIPS—transjugular intrahepatic portosystemic shunt). The authors discuss the current place of PCS, in obvious decline in comparison with the situation 50 years ago. The current methods of controlling variceal bleeding represent obvious progress. PCS remains with very limited indications, in specific situations when the other therapeutic methods have failed or are not recommended. Hindawi 2022-09-17 /pmc/articles/PMC9509272/ /pubmed/36164663 http://dx.doi.org/10.1155/2022/1382556 Text en Copyright © 2022 Petre Radu et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Radu, Petre
Prunoiu, Virgiliu-Mihail
Strâmbu, Victor
Garofil, Dragos
Doncu, Roxana Elena
Brătucu, Eugen
Simion, Laurentiu
Răvaş, Maria-Manuela
Brătucu, Mircea Nicolae
The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present
title The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present
title_full The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present
title_fullStr The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present
title_full_unstemmed The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present
title_short The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present
title_sort portosystemic shunt for the control of variceal bleeding in cirrhotic patients: past and present
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509272/
https://www.ncbi.nlm.nih.gov/pubmed/36164663
http://dx.doi.org/10.1155/2022/1382556
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