Document Detail


Surgical portosystemic shunts for treatment of portal hypertensive bleeding: outcome and effect on liver function.
MedLine Citation:
PMID:  10520919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Since the advent of liver transplantation and transjugular intrahepatic portosystemic shunts (TIPS), the role of surgical portosystemic shunts in the treatment of portal hypertension has changed. However, we have continued to use portosystemic shunts in patients with noncirrhotic portal hypertension and in patients with Child's A cirrhosis. METHODS: We performed 48 surgical portosystemic shunt procedures between 1988 and 1998. The outcomes of these patients were evaluated to assess the efficacy of this treatment. Data from 39 of 48 patients were available for analysis. The average follow-up was 42 months. RESULTS: Liver function generally remained stable for the patients; only 2 patients had progressive liver failure and required transplant procedures. Gastrointestinal bleeding (3 patients), encephalopathy (3 patients), and shunt thrombosis (3 patients) were rare. Patient survival was 81% at 4 years, similar to survival with liver transplantation (P = .22). CONCLUSIONS: Surgical shunts remain the treatment of choice for prevention of recurrent variceal bleeding in patients with good liver function and portal hypertension.
Authors:
S J Knechtle; A M D'Alessandro; M J Armbrust; A Musat; M Kalayoglu
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  126     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-10-25     Completed Date:  1999-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  708-11; discussion 711-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Wisconsin Medical School, Madison, USA.
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MeSH Terms
Descriptor/Qualifier:
Ammonia / blood
Bilirubin / blood
Cause of Death
Follow-Up Studies
Gastrointestinal Hemorrhage / surgery*
Graft Occlusion, Vascular
Humans
Hypertension, Portal / etiology,  mortality,  surgery*
Liver / blood supply,  physiopathology*,  surgery
Liver Cirrhosis, Alcoholic / complications,  surgery
Liver Cirrhosis, Biliary / complications,  surgery
Portacaval Shunt, Surgical*
Serum Albumin
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Serum Albumin; 635-65-4/Bilirubin; 7664-41-7/Ammonia

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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