Portal-systemic shunting in patients with non-alcoholic liver disease

Portal systemic shunting for the treatment of bleeding oesophageal varices in non-alcoholic patients is thought to have a better outcome than in patients with alcoholic portal hypertension. In a retrospective study of twenty-five non-alcoholic patients who had undergone portal systemic shunting for the treatment of bleeding oesophageal varices, the perioperative and long term mortality was found to be unacceptably high. Therefore, an analysis was made to define the factors which may have contributed to the high mortality. It was found that the presence of one or more of the following factors contributed to the patient's demise: presence of active liver disease at the time of surgery, previous abdominal surgery, and the performance of shunting as an emergency in order to stop bleeding. It is concluded that in patients having one or more of these risk factors, currently available non-operative means of treating bleeding oesophageal varices should be considered.