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Variceal hemorrhage in the veteran population. To shunt or not to shunt?
Am Surg. 1984 May; 50(5):264-9.AS

Abstract

Portasystemic decompression remains the most definitive procedure in the control of portal hypertension (PHT) and bleeding gastroesophageal varices (BGEV). However, controversy prevails regarding shunt timing, type, and even propriety, especially in alcoholics. Analysis of a recent portal hypertension questionnaire submitted to 75 university-affiliated Veterans Administration Medical Centers (VAMC) reflected optimism regarding portasystemic shunts for the management of bleeding varices; disappointingly, however, on the average, only 20 to 25 per cent of variceal bleeders underwent definitive surgical management of any type. Ending in January 1980, a 14-year experience at the Atlanta VAMC with 72 portasystemic shunts was reviewed and demonstrates that shunt procedures may be extended to the veteran, predominantly alcoholic, population. Criteria for successful patient selection and operation are presented. While elective variceal decompression, preferably by the distal splenorenal shunt operation, may be performed with minimal morbidity and mortality, more efficient control of alcoholism is essential to prevent late deaths from hepatic failure.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

6609655

Citation

Fulenwider, J T., et al. "Variceal Hemorrhage in the Veteran Population. to Shunt or Not to Shunt?" The American Surgeon, vol. 50, no. 5, 1984, pp. 264-9.
Fulenwider JT, Smith RB, Millikan WJ, et al. Variceal hemorrhage in the veteran population. To shunt or not to shunt? Am Surg. 1984;50(5):264-9.
Fulenwider, J. T., Smith, R. B., Millikan, W. J., Ansley, J. D., Salam, A. A., Henderson, J. M., & Warren, W. D. (1984). Variceal hemorrhage in the veteran population. To shunt or not to shunt? The American Surgeon, 50(5), 264-9.
Fulenwider JT, et al. Variceal Hemorrhage in the Veteran Population. to Shunt or Not to Shunt. Am Surg. 1984;50(5):264-9. PubMed PMID: 6609655.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variceal hemorrhage in the veteran population. To shunt or not to shunt? AU - Fulenwider,J T, AU - Smith,R B,3rd AU - Millikan,W J, AU - Ansley,J D, AU - Salam,A A, AU - Henderson,J M, AU - Warren,W D, PY - 1984/5/1/pubmed PY - 1984/5/1/medline PY - 1984/5/1/entrez SP - 264 EP - 9 JF - The American surgeon JO - Am Surg VL - 50 IS - 5 N2 - Portasystemic decompression remains the most definitive procedure in the control of portal hypertension (PHT) and bleeding gastroesophageal varices (BGEV). However, controversy prevails regarding shunt timing, type, and even propriety, especially in alcoholics. Analysis of a recent portal hypertension questionnaire submitted to 75 university-affiliated Veterans Administration Medical Centers (VAMC) reflected optimism regarding portasystemic shunts for the management of bleeding varices; disappointingly, however, on the average, only 20 to 25 per cent of variceal bleeders underwent definitive surgical management of any type. Ending in January 1980, a 14-year experience at the Atlanta VAMC with 72 portasystemic shunts was reviewed and demonstrates that shunt procedures may be extended to the veteran, predominantly alcoholic, population. Criteria for successful patient selection and operation are presented. While elective variceal decompression, preferably by the distal splenorenal shunt operation, may be performed with minimal morbidity and mortality, more efficient control of alcoholism is essential to prevent late deaths from hepatic failure. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/6609655/Variceal_hemorrhage_in_the_veteran_population__To_shunt_or_not_to_shunt L2 - https://medlineplus.gov/alcoholusedisorderaud.html DB - PRIME DP - Unbound Medicine ER -