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Supradiaphragmatic Transposition of the Spleen in Portal Hypertension

Robert N. McClelland, MD; Fouad A. Bashour, MD, PhD
Arch Surg. 1969;98(2):175-179. doi:10.1001/archsurg.1969.01340080067012.
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Many surgical procedures have been described for correction of portal hypertension and related esophageal-variceal hemorrhage and intractable ascites. One such procedure is supradiaphragmatic transposition of the spleen. The rational basis for supradiaphragmatic splenic transposition depends upon formation of portasystemic venous collaterals between the transposed spleen and thoracic systemic veins. The present study was designed to determine in the dog to what extent splenic supradiaphragmatic transposition is effective in relieving portal hypertension and ascites.

Methods  The experiments were divided into two groups. Group-1 experiments were designed to determine the effect of supradiaphragmatic splenic transposition on the reduction of ascites secondary to portal hypertension and on the prolongation of survival time in dogs with severe portal hypertension. The group-2 experiments were designed to determine the effect of splenic transposition on portal pressures per se and in relation to ascites reduction.Group 1.—The Effect of Splenic Transposition on Relief of Ascites and Prolongation


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