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THE ADVISABILITY of carrying out portal decompression operations on cirrhotic patients has been questioned by many thoughtful doctors. The objection has not been so much over whether the operative mortality rate is low enough to be acceptable or over whether the procedures are truly effective in precluding variceal hemorrhage, for both questions have effectively been answered affirmatively. Rather, it is argued that the cirrhotic liver presages such brief survival anyway that it is unrealistic to carry out a dangerous major operation which can be no more than prophylactic against one of the underlying disease's complications. In addition to having a shortened life, it is sometimes added, the cirrhotic patient very often cannot be made into a productive citizen, no matter what is done for him.
Down through the years the cirrhotic has been most unjustly maligned as a useless, often drunken derelict. Although patently inaccurate, this fictional image manages to
Palmer ED. Productivity of Cirrhotic Patients Following Portal Decompression. JAMA. 1962;181(10):897–899. doi:10.1001/jama.1962.03050360083019
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