Abstract
Distal splenorenal shunt is known as not so easy to perform, because of the procedures to divide many pancreatic tributaries. Then, we modified this operative technique by using an autologous external iliac vein graft. The graft was retroperitoneally retrieved without any reconstruction and the internal iliac vein was preserved to maintain co-lateral venous flow. The graft was interpositioned between the splenic and the left renal vein instead of end-to-side anastomosis of the splenic and left renal vein as the conventional method.
The procedure was applied in 3 patients with esophagogastric varices. Each graft was 4～5 cm in length and there was no difference in diameter between the splenic vein and the graft. The splenic vein was exposed in only 2 cm in dividing 3 or 4 pancreatic branches. In comparison with the conventional method, there was no statistical difference concerning the intraoperative blood loss, operative time and hospital stay after surgery. Postoperative evaluations revealed the good patency of the grafts and the improvement of the varices in all three patients. The swelling of the legs in which the grafts were retrieved was hardly appeared.
In conclusion, the autologous iliac vein graft is useful for simplifying the operative procedure of distal splenorenal shunt.
