A Controlled Trial of Prophylactic Portacaval-Shunt Surgery

PATIENTS with cirrhosis and varices often die after esophageal hemorrhage. In a retrospective analysis of the records of 106 patients appearing in the years 1918–1938 only 30 per cent survived for a year after esophageal hemorrhage.1 Replacement of massive blood loss, tamponade tubes, icewater lavage, emergency surgery and other measures have become common practice since 1938; yet a similar analysis of 102 veterans treated in the years 1946–1956 showed only a 31 per cent survival at one year,2 and the recent experience of the Boston Inter-Hospital Liver Group is that this figure remains unchanged.There have been only a few . . .