Elective portasystemic shunt: selection criteria, choice of procedure,results

Hottenrott, C.; Hanisch, E.

Langenbecks Archiv für Chirurgie. Supplement Ii Verhandlungen der Deutschen Gesellschaft für Chirurgie. Deutsche Gesellschaft für Chirurgie. Kongress 1990: 387-390


ISSN/ISBN: 0173-0541
PMID: 1983577
Document Number: 366279
The results of conservative medical (propranolol) and endoscopic therapy for bleeding esophageal varices show that the surgical shunt is indicated in both, acute and elective situations. The portocaval end-to-side-shunt should be preferred for hemodynamic reasons. However, special selection of patients is required to prevent postoperative liver failure. Linton, Drapanas and Warren shunts have a higher recurrence rate, but seem more appropriate for liver transplantation candidates. In our own series, preoperative diagnostic shunt-simulation by balloon-occlusion of the portal vein via an umbilical catheter has tremendously improved the results, even for child C-patients.

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