Central Surgical AssociationSurgical shunts and tips for variceal decompression in the 1990s*,**
Section snippets
Patient populations
The patient profiles for the 2 groups are summarized in Table I.Surgical shunts were performed in 73 patients from July 1992 to December 1999. Ten of these patients are excluded from this analysis because they are part of an ongoing prospective randomized controlled trial comparing distal splenorenal shunts (DSRSs) and TIPSs. Sixty-three patients are included in this analysis; 59 patients underwent selective variceal decompression, and 4 patients had total shunts. Selective shunts were 54
Patient status
The patient status is summarized for both groups in Table II.Empty Cell Surgical shunts (n) TIPS (n) Patients 63 200 Deaths Early (30 day) 0 51 Late 9 43 Transplantation 3 38 In follow-up 50 54 Lost to follow-up 1 14
The status of 62 of the 63 patients with surgical shunt is known; the only patient lost to follow-up was from overseas. The range of follow-up is from 1 to 80 months, with a median follow-up of 36 months. Five of the patients have not returned for follow-up visits, but their
Discussion
We report the experience at The Cleveland Clinic in the 1990s of patients who underwent decompression for portal hypertension. The groups, by design, are different and reflect this center's philosophy of providing surgical decompression for good-risk patients who have been refractory to endoscopic and pharmacologic therapy and of using TIPSs for poorer risk patients with refractory bleeding or for patients with portal hypertension and intractable ascites. A significant number of the patients
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Cited by (0)
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Reprint requests: J. Michael Henderson, MD, The Cleveland Clinic Foundation, 9500 Euclid Ave, A80, Cleveland, OH 44119.
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Surgery 2000;128:540-7