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    
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.
S J Knechtle; A M D'Alessandro; M J Armbrust; A Musat; M Kalayoglu
Related Documents :
10520919 - Surgical portosystemic shunts for treatment of portal hypertensive bleeding: outcome an...
10216009 - Transcatheter occlusion of the patent ductus arteriosus: use of the retrievable coil de...
7596499 - The role of endoscopic choroid plexus coagulation in the management of hydrocephalus.
1984509 - Shunt surgery for hydrocephalus in tuberculous meningitis: a long-term follow-up study.
7259059 - Connective tissue changes in autogenous vein graft used as a mesocaval shunt.
22927709 - Inflammatory mediators in induced sputum and airway hyperresponsiveness in cough varian...
21457209 - A 6-month maintenance therapy with adapalene-benzoyl peroxide gel prevents relapse and ...
18480969 - Alterations of aqueous flare and cells detected by laser flare-cell photometry in patie...
11666119 - Treatment of diabetic microangiopathy and edema with total triterpenic fraction of cent...
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    
Department of Surgery, University of Wisconsin Medical School, Madison, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Ammonia / blood
Bilirubin / blood
Cause of Death
Follow-Up Studies
Gastrointestinal Hemorrhage / surgery*
Graft Occlusion, Vascular
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
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

Previous Document:  Medical ethics curriculum for surgical residents: results of a pilot project.
Next Document:  Learning sentinel node biopsy: results of a prospective randomized trial of two techniques.