Effect of distal splenorenal shunt on survival of patients with primary biliary cirrhosis

Thomas D Boyer, Dennis D. Kokenes, Gary Hertzler, Michael H. Kutner, J. Michael Henderson

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Distal splenorenal shunt is known to effectively control bleeding from esophageal and gastric varices; however, the effect of this selective shunt on liver function is less well understood. We examined retrospectively the effect of distal splenorenal shunt on the survival of 19 patients with primary biliary cirrhosis subjected to surgery for bleeding varices over a 20-yr period and had been followed for at least 1 yr. Actual Kaplan-Meier survival curve was compared with predicted survival curve based on the Mayo Clinic model using clinical data collected at the time of surgery. The patients median length of follow-up was 65.9 mo. Ten of the 19 patients died or underwent orthotopic liver transplantation during the period of observation. The actual Kaplan-Meier and predicted Mayo Clinic model survival curves were similar and did not differ significantly. Survival was best in patients with good liver function (i.e., low Mayo risk scores). Distal splenorenal shunt, therefore, did not appear to have an adverse effect on the survival of patients with primary biliary cirrhosis. We conclude that variceal bleeding in primary biliary cirrhosis patients with good liver function should not be considered an indication for liver transplantation. Instead, if treatment with sclerotherapy or β-blockers fails then distal splenorenal shunt will prevent recurrent bleeding in 90% of patients and leave them with an excellent prognosis.

Original languageEnglish (US)
Pages (from-to)1482-1486
Number of pages5
JournalHepatology
Volume20
Issue number6
StatePublished - Dec 1994
Externally publishedYes

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Surgical Splenorenal Shunt
Biliary Liver Cirrhosis
Survival
Hemorrhage
Liver Transplantation
Liver
Sclerotherapy
Esophageal and Gastric Varices
Varicose Veins
Kaplan-Meier Estimate
Observation

ASJC Scopus subject areas

  • Hepatology

Cite this

Boyer, T. D., Kokenes, D. D., Hertzler, G., Kutner, M. H., & Henderson, J. M. (1994). Effect of distal splenorenal shunt on survival of patients with primary biliary cirrhosis. Hepatology, 20(6), 1482-1486.

Effect of distal splenorenal shunt on survival of patients with primary biliary cirrhosis. / Boyer, Thomas D; Kokenes, Dennis D.; Hertzler, Gary; Kutner, Michael H.; Henderson, J. Michael.

In: Hepatology, Vol. 20, No. 6, 12.1994, p. 1482-1486.

Research output: Contribution to journalArticle

Boyer, TD, Kokenes, DD, Hertzler, G, Kutner, MH & Henderson, JM 1994, 'Effect of distal splenorenal shunt on survival of patients with primary biliary cirrhosis', Hepatology, vol. 20, no. 6, pp. 1482-1486.
Boyer TD, Kokenes DD, Hertzler G, Kutner MH, Henderson JM. Effect of distal splenorenal shunt on survival of patients with primary biliary cirrhosis. Hepatology. 1994 Dec;20(6):1482-1486.
Boyer, Thomas D ; Kokenes, Dennis D. ; Hertzler, Gary ; Kutner, Michael H. ; Henderson, J. Michael. / Effect of distal splenorenal shunt on survival of patients with primary biliary cirrhosis. In: Hepatology. 1994 ; Vol. 20, No. 6. pp. 1482-1486.
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