Why the study?
Does distal splenorenal shunt reduce spontaneous encephalopathy and improve survival compared to end-to-side portacaval shunt in patients with variceal bleeding?
Population
80 patients with variceal bleeding
Comparison
Distal splenorenal (selective) shunt vs End-to-side portacaval shunt
Design
RCT, prospectively randomized
Follow-up
65-mo mean
Authors
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Selective shunts lower encephalopathy risk without survival difference; supports preference over nonselective shunts for variceal bleeding.
Does distal splenorenal shunt reduce spontaneous encephalopathy and improve survival compared to end-to-side portacaval shunt in patients with variceal bleeding?
Distal splenorenal shunts reduce the incidence and severity of spontaneous encephalopathy compared to end-to-side portacaval shunts, despite higher initial operative demands and slightly higher postoperative mortality, with similar long-term survival.
Langer et al. (1985) studied this question.
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