In our study of a controlled trial of therapeutic portacaval shunt, preliminary data suggest the superiority of surgical over medical treatment. Utilizing the Life-Table method of analysis, our data thus far indicate a 90% to 95% chance that five-year survival for those patients treated by an end-to-side portacaval shunt is 60%, while survival for those treated medically is 10%.
As a result of a prospective study, it is concluded that moderate to severe degrees of acute hyaline necrosis adversely influence survival after portacaval shunt in cirrhotic patients. Thus it is recommended that a liver biopsy precede consideration of either an emergency or an elective shunt.
Mikkelsen WP. Therapeutic Portacaval ShuntPreliminary Data on Controlled Trial and Morbid Effects of Acute Hyaline Necrosis. Arch Surg. 1974;108(3):302-305. doi:10.1001/archsurg.1974.01350270036007