Emergency portacaval shunt for XXXX . A prospective study.

@entity1 @entity1169 @entity548 @entity75 @entity409
Emergency portacaval shunt for @entity548 is associated with a high operative mortality, particularly if used as a last resort. Because of this, a strong case has been made against emergency shunt. This report describes an experience with emergency portacaval shunt for the treatment of @entity548 when used systematically after hemodynamic stabilization and control of the @entity548 episode with balloon tamponade, if necessary, in @entity1 with mild or moderate @entity409 . The population studied comprised 62 consecutive @entity1 who rebled from varices while participating in a controlled trial of @entity1169 for the prevention of rebleeding. Of the 62 @entity1 , nine died of massive @entity548 and 53 survived the @entity548 . Of the 53 survivors, 11 had severe @entity409 and were not considered for shunt surgery. Of the remaining 42 @entity1 with mild or moderate @entity409 , 36 had emergency central portacaval shunt. The interval between endoscopic diagnosis of @entity548 and surgery averaged 19 +/- 3 hours (mean +/- SE). The operative mortality rate, defined as in-hospital mortality, was 19%. One- and 2-year survival rates were 78% and 71%, respectively. The incidence of postoperative hepatic @entity75 was 36%; all @entity1 responded favorably to protein restriction and lactulose. Thus, under specific conditions, emergency portacaval shunt results in an acceptable long-term survival rate. In @entity1 with mild or moderate @entity409 , emergency portacaval shunt should be considered when other forms of treatment for the prevention of variceal rebleeding have failed.
