| Surgical portosystemic shunts for treatment of portal hypertensive bleeding: outcome and effect on liver function. | |
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MedLine Citation:
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PMID: 10520919 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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S J Knechtle; A M D'Alessandro; M J Armbrust; A Musat; M Kalayoglu |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Surgery Volume: 126 ISSN: 0039-6060 ISO Abbreviation: Surgery Publication Date: 1999 Oct |
Date Detail:
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Created Date: 1999-10-25 Completed Date: 1999-10-25 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 708-11; discussion 711-3 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University of Wisconsin Medical School, Madison, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Ammonia
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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:
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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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