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  • Title: [Current indications and results of elective truncal portacaval shunt. Apropos of 97 cases].
    Author: Assadourian R, Abitbol A, Berthet B.
    Journal: J Chir (Paris); 1988 Dec; 125(12):704-11. PubMed ID: 3265941.
    Abstract:
    The authors analyse the results of a series of 97 cases of elective porto-caval anastomoses for ruptured oesophageal varices and compare them with those of the literature. Elective porto-caval anastomosis satisfactorily prevents haemorrhagic recurrence (3%) at the cost of an operative mortality of 10% (nil over the last five years). Porto-caval encephalopathy was observed in 36% of cases with an incapacitating form (stage II or III) in 21% of operated patients and always represented the major disadvantage of surgery. However, the place of truncal porto-caval anastomosis is still intact in the prevention of recurrent haemorrhage from ruptured oesophageal varices. Warren's operation, the reference surgical technique, cannot be performed systematically because of technical reasons and/or because of rigorous selection. Endoscopic sclerotherapy represents a fundamental therapeutic procedure during the haemorrhagic period. Permanent haemostasis is more difficult to obtain and requires surgery in about 25% of cases. The mortality and morbidity associated with the endoscopic method are compared with the surgical results in two series of patients belonging to Child's groups A and B.
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