Which of the following statement(s) is/are true concerning the results of portosystemic shunting?
belongs to book: ASIR SURGICAL MCQs BANK|Dr. Gharama Al-Shehri|1st edition| Chapter number:7| Question number:122
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total answers (1)
belongs to book: ASIR SURGICAL MCQs BANK|Dr. Gharama Al-Shehri|1st edition| Chapter number:7| Question number:122
total answers (1)
a.When comparing shunts with nonshunting procedures, only minor differences in long-term survival are reported, but the mode of death usually changes
b.Distal splenorenal shunts are associated with the development of less hepatic encephalopathy
c.Survival statistics following distal splenorenal shunt in good risk patients (Child’s Class A) are in excess of 80%
Multiple randomized comparisons of distal splenorenal shunt with other types of portosystemic shunts have been reported. Operative mortality and long-term prognosis are similar, but patients undergoing distal splenorenal shunts develop less encephalopathy. Less encephalopathy is also seen with the selective Sarfeh shunt and after nonshunting procedures, such as sclerotherapy or devascularization. When comparing shunts with nonshunting procedures, only minor differences in long-term survival are reported, but the mode of death usually changes. With nonshunting procedures, a greater proportion of patients die of recurrent hemorrhage; after construction of a shunt, a greater proportion die of hepatic failure. Class A patients undergoing distal splenorenal shunts can be predicted to have an actuarial survival including operative mortality in excess of 80%. This is a substantial improvement over previous experience with portocaval shunts and is likely better than the results that can be obtained with hepatic transplantation.
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