title: Which portosystemic shunt is best?
abstract: No single shunt operation is ideal for all patients or all circumstances. The selective distal splenorenal shunt is preferred for the majority of patients, because it has the potential to preserve hepatic portal perfusion. Most evidence suggests that the distal splenorenal shunt is followed by a lower frequency of encephalopathy than is any type of nonselective shunt. Although theoretically attractive, the small-diameter interposition portacaval shunt has not yet been subjected to the scrutiny of controlled trials.
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha.
authors.forename: L F
authors.initials: LF
authors.lastname: Rikkers
authors.forename: W T
authors.initials: WT
authors.lastname: Sorrell
authors.forename: G
authors.initials: G
authors.lastname: Jin
mesh_terms: D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006501:Hepatic Encephalopathy / Q000209:etiology; D006801:Humans; D011167:Portacaval Shunt, Surgical / Q000009:adverse effects / Q000379:methods; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects / Q000145:classification / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D013164:Splenorenal Shunt, Surgical / Q000009:adverse effects / Q000379:methods