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The narrow\u2010diameter interposition portacaval H\u2010graft using 8\u00a0mm polytetraffuoroethylene has been performed in 32 patients at our institution with low operativ mortality (16.3%) and nearly complete cessation of variceal bleeding (96.7%) over a mean follow\u2010up period of 43\u00a0months. In comparison with total shunts, diminished rates of postshunt encephalopathy (13% versus 40%) have been observed. Prograde portal blood flow has been preserved in 90% of 30 patients studied by perioperative portography. Shunt patency with continued prograde flow has been demonstrated at up to 9 years of follow\u2010up. Investigators at three other centers have studied partial shunting using substantially similar techniques, with similar findings. Based on these results, we conclude that narrow\u2010diameter shunts provide effective, long\u2010lasting treatment for variceal hemorrhage due to portal hypertension in the alcoholic.<\/jats:p>","DOI":"10.1007\/bf00294403","type":"journal-article","created":{"date-parts":[[2004,10,6]],"date-time":"2004-10-06T08:28:25Z","timestamp":1097051305000},"page":"211-215","source":"Crossref","is-referenced-by-count":43,"title":["Narrow\u2010diameter portacaval shunts for management of variceal bleeding"],"prefix":"10.1002","volume":"18","author":[{"given":"John Craig","family":"Collins","sequence":"first","affiliation":[{"name":"Surgical Service (112) Veterans Affairs Medical Center 5901 East 7th Street 90822 Long Beach California USA"},{"name":"Department of Surgery University of California Irvine Medical Center Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric B.","family":"Rypins","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Illinois at Chicago Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I. James","family":"Sarfeh","sequence":"additional","affiliation":[{"name":"Surgical Service (112) Veterans Affairs Medical Center 5901 East 7th Street 90822 Long Beach California USA"},{"name":"Department of Surgery University of California Irvine Medical Center Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1994,3]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"2","article-title":"Cancer statistics","volume":"37","author":"Silverberg E.","year":"1987","journal-title":"CA"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80872-4"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196709000-00011"},{"key":"e_1_2_1_5_1","first-page":"663","article-title":"Selectivity of the distal splenorenal shunt","volume":"86","author":"Maillard J.N.","year":"1979","journal-title":"Surgery"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80400-3"},{"key":"e_1_2_1_7_1","first-page":"610","article-title":"Partial portacaval shunt: renaissance of an old concept","volume":"111","author":"Adam R.","year":"1992","journal-title":"Surgery"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(91)90378-Q"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)81075-X"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198905253202107"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8553(21)00184-9"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198309000-00009"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197805000-00008"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(85)80008-8"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197402000-00019"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-4804(87)90169-7"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198304000-00008"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198610000-00003"},{"key":"e_1_2_1_19_1","first-page":"223","article-title":"Clinical implications of portal hemodynamics after small\u2010diameter portacaval H\u2010graft","volume":"96","author":"Sarfeh I.J.","year":"1984","journal-title":"Surgery"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(88)80273-3"},{"key":"e_1_2_1_21_1","first-page":"335","article-title":"Quantitation and fractionation of nutrient hepatic blood flow in normal persons, in persons with portal hypertensive cirrhosis, and after smalldiameter portacaval H\u2010grafts","volume":"104","author":"Rypins E.B.","year":"1988","journal-title":"Surgery"},{"key":"e_1_2_1_22_1","first-page":"528","article-title":"Prospective comparison of partial versus total portal decompression for bleeding esophageal varices","volume":"175","author":"Johansen K.","year":"1992","journal-title":"Surg. 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