Ascites in cirrhosis: a medical or surgical problem?
| Autor: | M D Leroy Shear |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
High rate
Liver Cirrhosis medicine.medical_specialty Cirrhosis Hepatology business.industry medicine.medical_treatment Encephalopathy Ascites medicine.disease Gastroenterology Surgery Peritoneovenous shunt Internal medicine Heart failure Medicine Humans medicine.symptom Portosystemic shunt business Clearance |
| Zdroj: | Hepatology (Baltimore, Md.). 11(2) |
| ISSN: | 0270-9139 |
| Popis: | Fifty-seven cirrhotic patients with intractable ascites had a portosystemic shunt. In 35 patients, a peritoneovenous shunt had previously failed. Forty-six patients were in Pugh's class B and 11 were in class C. There were three operative deaths (5.3%). Fifty-three (98.2%) of the 54 survivors were cleared of ascites. In one patient, ascites persisted because of postshunt heart failure that resulted in a marked increase of caval pressure. Twenty-seven patients (50%) had late encephalopathy, which was severe and disabling in 12 (22%). One-and three-year survival rates were 72% and 36%, respectively. These results suggest that although portosystemic shunts are remarkably effective in dealing with ascites, the high rate of postoperative encephalopathy is a strong argument against their routine use in the management of intractable ascites in cirrhosis. |
| Databáze: | OpenAIRE |
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