[Splenorenal anastomoses]

Abstract

Of the operative procedures that can be used to relieve the pressure in portal hypertension, the authors prefer the terminolateral splenorenal anastomosis if the assessment of relative anatomical positions and the patient's hemodynamic situation has shown that these are adequate for the procedure. In contrast to portacaval shunting, after splenorenal anastomosis portal blood supply to the liver is partially maintained. Therefore less patients suffer from hepatic failure or encephalopathy. In addition a lower short-and long-term postoperative mortality has been observed. The risk of thrombosis and recurrent bleeding are the drawback of the method, occurring in about 15% of the patients. A meticulous technique can reduce this percentage.