A quarter of a century of portasystemic shunting for oesophageal varices
Deans, G.T.; Spence, R.A.; Johnston, G.W.
Journal of the Royal College of Surgeons of Edinburgh 34(1): 37-39
1989
ISSN/ISBN: 0035-8835 PMID: 2709357 Document Number: 327276
Seventy-three patients who had received portasystemic shunts were reviewed to assess the current role of this procedure in the treatment of portal hypertension. Survival at 1, 5 and 10 years was 85%, 68% and 45% respectively. Survival was significantly greater (P less than 0.001) in Child's grade A patients compared with Child's grade B patients and in non-alcoholics compared with alcoholics. Previously absent encephalopathy developed in 43% of those with non-selective shunts compared with 21% of those with selective shunts. Six of the 12 patients who experienced recurrent variceal haemorrhage had associated shunt thrombosis: five of these required further shunts or oesophageal transection to control their bleeding and the other patient died before further surgery could be instituted. Shunt surgery still has a role in the treatment of a small number of carefully selected patients with portal hypertension.