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Surgical portosystemic shunts for treatment of portal hypertensive bleeding: outcome and effect on liver function.

Publication ,  Journal Article
Knechtle, SJ; D'Alessandro, AM; Armbrust, MJ; Musat, A; Kalayoglu, M
Published in: Surgery
October 1999

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.

Duke Scholars

Published In

Surgery

ISSN

0039-6060

Publication Date

October 1999

Volume

126

Issue

4

Start / End Page

708 / 711

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Analysis
  • Surgery
  • Serum Albumin
  • Portacaval Shunt, Surgical
  • Liver Cirrhosis, Biliary
  • Liver Cirrhosis, Alcoholic
  • Liver
  • Hypertension, Portal
  • Humans
 

Citation

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MLA
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Knechtle, S. J., D’Alessandro, A. M., Armbrust, M. J., Musat, A., & Kalayoglu, M. (1999). Surgical portosystemic shunts for treatment of portal hypertensive bleeding: outcome and effect on liver function. Surgery, 126(4), 708–711.
Knechtle, S. J., A. M. D’Alessandro, M. J. Armbrust, A. Musat, and M. Kalayoglu. “Surgical portosystemic shunts for treatment of portal hypertensive bleeding: outcome and effect on liver function.Surgery 126, no. 4 (October 1999): 708–11.
Knechtle SJ, D’Alessandro AM, Armbrust MJ, Musat A, Kalayoglu M. Surgical portosystemic shunts for treatment of portal hypertensive bleeding: outcome and effect on liver function. Surgery. 1999 Oct;126(4):708–11.
Knechtle, S. J., et al. “Surgical portosystemic shunts for treatment of portal hypertensive bleeding: outcome and effect on liver function.Surgery, vol. 126, no. 4, Oct. 1999, pp. 708–11.
Knechtle SJ, D’Alessandro AM, Armbrust MJ, Musat A, Kalayoglu M. Surgical portosystemic shunts for treatment of portal hypertensive bleeding: outcome and effect on liver function. Surgery. 1999 Oct;126(4):708–711.
Journal cover image

Published In

Surgery

ISSN

0039-6060

Publication Date

October 1999

Volume

126

Issue

4

Start / End Page

708 / 711

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Analysis
  • Surgery
  • Serum Albumin
  • Portacaval Shunt, Surgical
  • Liver Cirrhosis, Biliary
  • Liver Cirrhosis, Alcoholic
  • Liver
  • Hypertension, Portal
  • Humans