Journal Basic Info

  • Impact Factor: 1.995**
  • H-Index: 8
  • ISSN: 2474-1647
  • DOI: 10.25107/2474-1647
**Impact Factor calculated based on Google Scholar Citations. Please contact us for any more details.

Major Scope

  •  Vascular Surgery
  •  Robotic Surgery
  •  Neurological Surgery
  •  Pediatric Surgery
  •  Surgical Oncology
  •  Orthopaedic Surgery
  •  Emergency Surgery
  •  Otolaryngology - Head and Neck Surgery

Abstract

Citation: Clin Surg. 2021;6(1):3157.Research Article | Open Access

Laparoscopic Distal Splenorenal Anastomosis

Dzidzava II1*, Kotiv BN1 , Onnicev IE1 , Soldatov SA1 , Smorodskiy AV1 , Shevcov SV1 , Bugaev SA1,2 and Apollonov AA1

1 Department of Hospital Surgery - Head of the Hospital Surgery Clinic, Military Medical Academy named after S.M. Kirova, St. Petersburg, Russia 2 A.V. Vishnevsky National Medical Research Center of Surgery, Moscow, Russia

*Correspondance to: Dzidzava II 

 PDF  Full Text DOI: 10.25107/2474-1647.3157

Abstract

Introduction: Esophagogastric bleeding is the most formidable complication of the portal hypertension syndrome. At acute bleeding from varicose veins of the esophagus and stomach, mortality reaches 40% to 50% and is accompanied with the high risk of early hemorrhage recurrence in 30% to 50% of survivors. Portosystemic shunt surgery provides for radical decompression of the portal vein system and reliably prevents hemorrhage recurrence. Purpose: To assess the possibility and efficacy of the Distal Splenorenal Anastomosis (DSRA) with a minimally invasive laparoscopic approach. Methods: The study included 28 patients with portal hypertension syndrome who underwent laparoscopic DSRA. By the Child-Pugh scale, class A was 42.9%, class B - 57.1%. The indication for surgical decompression of the portal system was the ineffectiveness of repeated sessions of endoscopic ligation with recurrence of varicose veins of the esophagus (21.5%) and/or bleeding from them (46.4%) or the presence of varicose veins of the stomach (32.1%). Results: Mean surgery time was 294 ? 86 minutes. The maximum blood loss was 211 ? 55 ml. The access conversion was performed in 10.7% of cases. In the postoperative period, the patients were in ICU for 1 to 2 days. The hospital stay and in-patients treatment duration was 9.4 ? 2.5 days. Both in the early and in the long-term follow-up, there were no cases of gastroesophageal bleeding and shunt thrombosis. The portosystemic encephalopathy developed in 12% of cases. The surgical decompression of the portal system was featured by a decrease in the degree of esophagus variation in the long-term period. The maximum follow-up period was 46 months. Conclusion: Minimally invasive laparoscopic DSRA in patients with portal hypertension syndrome is a possible, safe and effective alternative treatment option.

Keywords

Portal hypertension; Bleeding from varicose veins of the esophagus; Portocaval shunt; Distal splenorenal anastomosis

Cite the article

Dzidzava II, Kotiv BN, Onnicev IE, Soldatov SA, Smorodskiy AV, Shevcov SV, et al. Laparoscopic Distal Splenorenal Anastomosis. Clin Surg. 2021; 6: 3157.

Search Our Journal

Journal Indexed In

Articles in PubMed

Monitoring an Ongoing Enhanced Recovery after Surgery (ERAS) Program: Adherence Improves Clinical Outcomes in a Comparison of Three Thousand Colorectal Cases
 PubMed  PMC  PDF  Full Text
Sildenafil Transiently Delays Early Alveolar Bone Healing of Tooth Extraction Sockets
 PubMed  PMC  PDF  Full Text
View More...

Articles with Grants

Satisfactory Outcome with Low Activated Clotting Time (<150 Seconds) in Extracorporeal Membrane Oxygenation
 Abstract  PDF  Full Text
Primary Tuberculosis of the Oral Cavity Presenting as the Ulcers: A Case Report
 Abstract  PDF  Full Text
View More...