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[Portal hypertension and variceal bleeding: shunt in concomitant or general prehepatic block].
Langenbecks Arch Chir Suppl Kongressbd. 1998; 115:443-50.LA

Abstract

Thrombosis of the portal system should be ruled out in all patient with esophagogastric varices. Such patients with no evidence of concomitant liver disease and with a high risk of rebleeding (e.g. gastric varices, low platelet counts, endoscopic criteria) should be referred to decompressive shunt surgery. The type of shunt is dictated by the patent segments of the portal system. Splenectomy should be avoided. The results show a low operative mortality, a zero encephalopathy and a low rebleeding rate. Patients with prehepatic thrombosis and liver cirrhosis represent a more severe problem since the risk and mortality of variceal hemorrhage is high and on the other hand TIPS procedure and liver transplantation may be impossible. In case of a high risk of rebleeding or endoscopic therapy failure we advocate surgical shunting as the risk of encephalopathy appears to be low when portal flow diversion already exists.

Authors+Show Affiliations

Hirner A
Klinik und Poliklinik für Chirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn.
Ulrich A
No affiliation info available
Wolff M
No affiliation info available

MeSH

AdolescentAdultAgedChildEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHumansHypertension, PortalLiver CirrhosisLiver TransplantationMaleMiddle AgedPortal VeinPortasystemic Shunt, SurgicalPortasystemic Shunt, Transjugular IntrahepaticPrognosisRecurrenceRiskThrombosis

Pub Type(s)

English Abstract
Journal Article
Review

Language

ger

PubMed ID

9931656

Citation

Hirner, A, et al. "[Portal Hypertension and Variceal Bleeding: Shunt in Concomitant or General Prehepatic Block]." Langenbecks Archiv Fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft Fur Chirurgie. Kongress, vol. 115, 1998, pp. 443-50.
Hirner A, Ulrich A, Wolff M. [Portal hypertension and variceal bleeding: shunt in concomitant or general prehepatic block]. Langenbecks Arch Chir Suppl Kongressbd. 1998;115:443-50.
Hirner, A., Ulrich, A., & Wolff, M. (1998). [Portal hypertension and variceal bleeding: shunt in concomitant or general prehepatic block]. Langenbecks Archiv Fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft Fur Chirurgie. Kongress, 115, 443-50.
Hirner A, Ulrich A, Wolff M. [Portal Hypertension and Variceal Bleeding: Shunt in Concomitant or General Prehepatic Block]. Langenbecks Arch Chir Suppl Kongressbd. 1998;115:443-50. PubMed PMID: 9931656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Portal hypertension and variceal bleeding: shunt in concomitant or general prehepatic block]. AU - Hirner,A, AU - Ulrich,A, AU - Wolff,M, PY - 1999/2/5/pubmed PY - 1999/2/5/medline PY - 1999/2/5/entrez SP - 443 EP - 50 JF - Langenbecks Archiv fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft fur Chirurgie. Kongress JO - Langenbecks Arch Chir Suppl Kongressbd VL - 115 N2 - Thrombosis of the portal system should be ruled out in all patient with esophagogastric varices. Such patients with no evidence of concomitant liver disease and with a high risk of rebleeding (e.g. gastric varices, low platelet counts, endoscopic criteria) should be referred to decompressive shunt surgery. The type of shunt is dictated by the patent segments of the portal system. Splenectomy should be avoided. The results show a low operative mortality, a zero encephalopathy and a low rebleeding rate. Patients with prehepatic thrombosis and liver cirrhosis represent a more severe problem since the risk and mortality of variceal hemorrhage is high and on the other hand TIPS procedure and liver transplantation may be impossible. In case of a high risk of rebleeding or endoscopic therapy failure we advocate surgical shunting as the risk of encephalopathy appears to be low when portal flow diversion already exists. SN - 0942-2854 UR - https://www.unboundmedicine.com/medline/citation/9931656/[Portal_hypertension_and_variceal_bleeding:_shunt_in_concomitant_or_general_prehepatic_block]_ L2 - http://www.diseaseinfosearch.org/result/5881 DB - PRIME DP - Unbound Medicine ER -