Prospective comparative clinical trial with distal splenorenal and mesocaval shunts.
In a randomized study, the rate of postshunt encephalopathy was significantly lower after distal splenorenal shunting than after mesocaval shunting. Either shunt can be performed electively with a low operative mortality. If initial hemorrhage cannot be controlled, mortality may be minimized by mesocaval shunting. Advanced cirrhosis is not a contraindication to elective or emergency portasystemic shunting.
D001807:Blood Vessel Prosthesis / Q000009:adverse effects / Q000401:mortality; D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000601:surgery; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000517:prevention & control; D006519:Hepatitis, Alcoholic / Q000401:mortality; D006801:Humans; D008642:Mesenteric Veins / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D012082:Renal Veins / Q000601:surgery*; D013162:Splenic Vein / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery*