[Elective portasystemic shunt: selection criteria, choice of procedure,results].
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.
Hottenrott
C
C
Chirurgische Universitätsklinik Frankfurt.
Hanisch
E
E
D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality; D015996:Survival Rate