Prophylactic Portacaval Anastomosis in Cirrhotic Patients with Esophageal Variees. A Progress Report of a Continuing Study

Conn, Harold O.; Lindenmuth, W. W.

doi:10.1097/00043764-196603000-00019

Cited by 2 publications

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“…For example, the American Association for the Study of Liver Diseases (AASLD) cites increased rates of HE and reductions in overall survival. [20][21][22][23][24] Preemptive or "Early" TIPS Patients with acute variceal hemorrhage should get aggressive volume resuscitation in combination with antibiotics, vasoactive medications, and EBL. 3 Once the acute bleeding has been treated, decompression of the varices through TIPS placement can minimize the risk of recurrent hemorrhage, which is especially true for patients with advanced liver disease who are at increased risk of treatment failure and overall mortality.…”

Section: Primary Prophylaxismentioning

confidence: 99%

Variceal Hemorrhage: Decompression, Obliteration, or Both?

McCafferty

Khudari

Salei

et al. 2022

Digestive Disease Interventions

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Variceal hemorrhage is a morbid condition that frequently mandates the involvement of interventional radiology to achieve successful and sustained hemostasis. Primary image-guided therapies for variceal hemorrhage include a transjugular intrahepatic portosystemic shunt and transvenous obliteration. Knowledge of variceal pathophysiology and anatomy, current techniques, and the evidence supporting therapeutic selection is paramount to successful patient outcomes. The purpose of this review is to provide the reader a framework of the available literature on image-guided management of bleeding varices to assist in clinical management.

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Section: Primary Prophylaxismentioning

confidence: 99%

Variceal Hemorrhage: Decompression, Obliteration, or Both?

McCafferty

Khudari

Salei

et al. 2022

Digestive Disease Interventions

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“…Patients undergoing medical therapy most commonly died of variceal hemorrhage while in contrast patients undergoing portacaval shunt overwhelmingly died from liver failure as shown in Figure 1. 5…”

Section: Early Years As a New Investigatormentioning

confidence: 99%

“…Comparison of cause of death in shunted and nonshunted patients in controlled series. Patients undergoing portacaval shunting died predominately from hepatic failure while those treated medically died from variceal hemorrhage 5. …”

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confidence: 99%

W. Dean Warren, MD, FACS, Father of Selective Shunts for Variceal Hemorrhage: Lessons Learned

Richards

2020

The American Surgeon

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Dr Dean Warren was born in 1924 and died prematurely from cancer in 1989. He was a man of uncommon intelligence, wit, collegiality, integrity, honesty, and a true leader in American surgery. In 1966, he and his colleagues (Drs Zeppa and Fomon) presented a new concept for surgical shunts to control variceal hemorrhage while maintaining portal perfusion or hepatopetal blood flow. He termed this new shunt the distal splenorenal shunt (DSRS), which was the first selective shunt invented. The DSRS selective shunt was a brilliant improvement over the total shunt concept proposed by Nicolai Eck and was practiced worldwide during the 1980s. In a space of 2 decades, Dr Warren’s pioneering work would show that the selective DSRS was superior to total shunts for treatment of portal hypertension, but that endoscopic sclerotherapy was a better first-line treatment for variceal hemorrhage than his own creation. His absolute adherence to the principles he espoused in his presidential address to the Society for Surgery of the Alimentary Tract in 1973 were employed in his research and treatment of patients. This paper details Dr Warren’s extraordinary research accomplishments and sets a lesson for us that well-designed clinical trials including randomization are essential in the advancement of the care of surgical patients.

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Prophylactic Portacaval Anastomosis in Cirrhotic Patients with Esophageal Variees. A Progress Report of a Continuing Study

Cited by 2 publications

References 0 publications

Variceal Hemorrhage: Decompression, Obliteration, or Both?

Variceal Hemorrhage: Decompression, Obliteration, or Both?

W. Dean Warren, MD, FACS, Father of Selective Shunts for Variceal Hemorrhage: Lessons Learned

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