Criteria for selection of patients for emergency portacaval shunt.
A computer program analysis of the effect on survival of 74 preoperative factors was performed as part of a prosepctive study of the emergency portacaval shunt in 146 unselected patients with bleeding esophageal varices due to alcoholic cirrhosis. Only ascites, a serum glutamic oxalacetic transaminase level of 100 units or more, and a requirement for 5,000 ml or more of blood transfusion were associated with a statistically significant decrease in survival. However, none of these factors are contraindications to operation because their presence permits a survival rate of 37 to 40%. The only contraindication to emergency portacaval shunt is the combined presence of ascites, jaundice, encephalopathy, and severe muscle wasting, a constellation that was incompatible with survival beyond one year.
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications; D001219:Aspartate Aminotransferases / Q000097:blood; D001803:Blood Transfusion; D001927:Brain Diseases / Q000150:complications; D004630:Emergencies; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D007565:Jaundice / Q000150:complications; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications; D011167:Portacaval Shunt, Surgical / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies
D001219:Aspartate Aminotransferases