Portasystemic Venous Shunts

Abstract

(Second of Two Parts)[Emergency end-to-side portacaval shunt.] For dependable relief of portal hypertension, emergency shunts for bleeding varices must decompress the splanchnic system immediately draining into the portal vein; in practice, the options for gaining this goal are overwhelmingly the portacaval and H-graft mesocaval shunts. Peripheral splanchnic shunts are considerably less effective.Although the quality of life after an emergency shunt compared with life after an elective shunt has not been scrutinized, it seems reasonable to recommend an urgent end-to-side portacaval shunt (within 18 hours of the bleeding episode) for Child's class A patients who would otherwise be offered . . .