{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T09:37:25Z","timestamp":1708940245567},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2004,3,29]],"date-time":"2004-03-29T00:00:00Z","timestamp":1080518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,5,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In the present era of liver transplantation and transjugular intrahepatic portosystemic shunts, the role and choice of shunt surgery for portal hypertension was reviewed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective study analysed the management of patients with portal hypertension in a tertiary liver transplant unit between June 1993 and May 2002. During this 9-year interval, 394 patients underwent endoscopic control of varices, 235 transjugular intrahepatic portosystemic shunts were inserted, 1142 liver transplants were performed, while only 29 patients needed a surgical portosystemic shunt.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-nine shunt operations were performed in nine patients with cirrhosis, one patient with congenital hepatic fibrosis and 19 without parenchymal liver disease. There were 12 side-to-side lienorenal, nine mesocaval, three proximal lienorenal, two distal lienorenal, two portacaval and one mesoportal shunts. Encephalopathy was seen in five of 11 patients with a non-selective shunt, but did not occur after side-to-side or selective lienorenal shunt procedures. At a median follow-up of 42\u00b75 months, one mesocaval shunt had thrombosed and one portacaval shunt had stenosed; both were successfully managed by percutaneous intervention. To date, six patients have died; two succumbed to postoperative complications, one of which was related to the shunt.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients with Budd\u2013Chiari syndrome and cirrhosis can nearly always be managed by a combination of endoscopy, interventional radiology and liver transplantation. In the rare instances when these therapies fail in patients with cirrhosis, a side-to-side lienorenal shunt is a good option.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.4526","type":"journal-article","created":{"date-parts":[[2004,3,29]],"date-time":"2004-03-29T16:02:14Z","timestamp":1080576134000},"page":"769-773","source":"Crossref","is-referenced-by-count":16,"title":["Role of surgical portosystemic shunts in the era of interventional radiology and liver transplantation"],"prefix":"10.1093","volume":"91","author":[{"given":"T","family":"Orug","sequence":"first","affiliation":[{"name":"Hepatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z F","family":"Soonawalla","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Tekin","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S P","family":"Olliff","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J A C","family":"Buckels","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A D","family":"Mayer","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2004,3,29]]},"reference":[{"key":"2021070907131031900_bib1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s11938-002-0009-y","article-title":"Variceal hemorrhage","volume":"5","author":"Brandenburger","year":"2002","journal-title":"Curr Treat Options Gastroenterol"},{"key":"2021070907131031900_bib2","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/S1089-3261(05)70176-8","article-title":"Portal hypertension","volume":"5","author":"Garcia","year":"2001","journal-title":"Clin Liver Dis"},{"key":"2021070907131031900_bib3","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s002680020380","article-title":"Transjugular intrahepatic portosystemic shunt: present status, comparison with endoscopic therapy and shunt surgery, and future prospectives","volume":"25","author":"Rosch","year":"2001","journal-title":"World J Surg"},{"key":"2021070907131031900_bib4","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S0889-8553(21)00184-9","article-title":"Which portosystemic shunt is best?","volume":"21","author":"Rikkers","year":"1992","journal-title":"Gastroenterol Clin North Am"},{"key":"2021070907131031900_bib5","first-page":"626","article-title":"Side-to-side splenorenal anastomosis with splenic preservation for portal hypertension","volume":"116","author":"Cooley","year":"1963","journal-title":"Surg Gynecol Obstet"},{"key":"2021070907131031900_bib6","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0022-3468(78)80212-7","article-title":"Extrahepatic portal hypertension: a review of 70 cases","volume":"13","author":"Mitra","year":"1978","journal-title":"J Pediatr Surg"},{"key":"2021070907131031900_bib7","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/0022-3468(93)90239-H","article-title":"Side-to-side lienorenal shunt without splenectomy in noncirrhotic portal hypertension in children","volume":"28","author":"Mitra","year":"1993","journal-title":"J Pediatr Surg"},{"key":"2021070907131031900_bib8","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1016\/S0022-3476(83)80461-2","article-title":"Portal obstruction in children. 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