Portasystemic Venous Shunts

Abstract

(First of Two Parts)Although the number of well controlled studies now exceeds the four identified a decade ago,¹ they clarify the role of portasystemic venous shunts for treatment of hepatic disease only a little better. Proper investigations based on sound statistical methods are often confounded by clinical exigencies.From the best studies of portasystemic venous shunts and the areas of agreement among others, I conclude:Successful portasystemic shunts reduce the likelihood of bleeding from esophageal varices.Protection from bleeding varices is virtually guaranteed after a portacaval shunt; it is less sure after other shunts.Portasystemic shunts are valuable treatment . . .