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• W2021527440 abstract "Editorials1 April 1969Prophylactic Portacaval ShuntsHAROLD O. CONN, M.D.HAROLD O. CONN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-4-859 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt is no easy task to pick one's way from truth to truth through besetting errors.PETER MERE LATHAMThe final report of the Boston Inter-Hospital Liver Group (BILG) study of prophylactic portacaval shunt in this issue of the ANNALS (1) is a landmark in clinical investigation. It illustrates a number of new and necessary trends in use by investigators who study patients.First, this project was designed to come to grips with one of the most controversial problems of medicine. It does not concern itself with peripheral aspects of portal hypertension but faces directly the core issues:Can portal...References1. RESNICKCHALMERSISHIHARAGARCEAUCALLOWSCHIMMELO'HARA RHTCAMAJADEMET: A controlled study of the prophylactic portacaval shunt. A final report. Ann. Intern. Med. 70: 675, 1969. LinkGoogle Scholar2. RATNOFFPATEK ODAJ: The natural history of Laennec's cirrhosis of the liver. An analysis of 386 cases. Medicine (Balt.) 21: 207, 1942. CrossrefGoogle Scholar3. NACHLASO'NEILCAMPBELL MMJEAJ: The life history of patients with cirrhosis of the liver and bleeding esophageal varices. Ann. Surg. 141: 10, 1955. CrossrefMedlineGoogle Scholar4. COHNBLAISDELL RFW: The natural history of the patient with cirrhosis of the liver with esophageal varices following the first massive hemorrhage. Surg. Gynec. Obstet. 106: 699, 1958. MedlineGoogle Scholar5. COHN R: A skeptical evaluation of portacaval anastomosis for gastrointestinal hemorrhage of cirrhosis of the liver. Stanford Med. Bull. 9: 231, 1951. MedlineGoogle Scholar6. NACHLAS MM: A critical evaluation of venous shunts for the treatment of cirrhotic patients with esophageal varices. Ann. Surg. 148: 169, 1958. CrossrefMedlineGoogle Scholar7. CHALMERS TC: The management of hepatic coma. A continuing problem. Med. Clin. N. Amer. 52: 1475, 1968. CrossrefMedlineGoogle Scholar8. PALMERJAHNKEHUGHES EDEJCW: Evaluation of clinical results of portal decompression in cirrhosis. JAMA 164: 746, 1957. CrossrefMedlineGoogle Scholar9. JACKSONPERRINSMITHDAGRADINADAL FCEBAGAEHM: A clinical investigation of the portacaval shunt. II. Survival analysis of the prophylactic operation. Amer. J. Surg. 115, 22, 1967. CrossrefGoogle Scholar10. CONNLINDENMUTH HOWW: Prophylactic portacaval anastomosis in cirrhotic patients with esophageal varices. Interim results with suggestions for subsequent investigations. New Eng. J. Med. 279: 725, 1968. CrossrefGoogle Scholar11. CONNSMITHBRODOFF HOHM: Observer error in the endoscopic diagnosis of esophageal varices. New Eng. J. Med. 272: 830, 1965. CrossrefMedlineGoogle Scholar12. KIRSHBLACKWELLBENNETT IECCHD: Roentgen diagnosis of esophageal varices. Comparison of roentgen and esophagoscopic findings in 502 cases. Amer. J. Roentgen. 74: 477, 1955. Google Scholar13. PETERNELDAGRADIROGERSNADALPERRINJACKSON WWAEAIHMEBFC: Clinical investigation of the portacaval shunt III. The diagnosis of esophageal varices. JAMA 202: 1081, 1967. CrossrefMedlineGoogle Scholar14. GREENEWEISBERGROSENTHALKATZ LHWSD: Evaluation of esophageal varices in liver disease by splenic-pulp pressure manometry, splenoprotography and esophagogastroscopy. Amer. J. Dig. Dis. 10: 284, 1965. CrossrefMedlineGoogle Scholar15. PALMERBRICK EDIH: Correlation of the severity of esophageal varices in portal cirrhosis and propensity to hemorrhage. Gastroenterology 30: 85, 1956. CrossrefMedlineGoogle Scholar16. BAKERSMITHLIEBERMANN LACG: The natural history of esophageal varices. A study of 115 cirrhotic patients in whom varices were diagnosed prior to bleeding. Amer. J. Med. 26: 228, 1959. CrossrefMedlineGoogle Scholar17. CONNLINDENMUTH HOWW: Prophylactic portacaval anastomosis in cirrhotic patients with esophageal varices and ascites. Experimental design and preliminary results. Amer. J. Surg. In press. Google Scholar18. HALLENBECKCOMESSWOLLAEGERGAGE GAMSEERP: Bleeding varices due to cirrhosis. Survival after (1) non surgical treatment, (2) splenectomy with or without omentopexy, and (3) portacaval or splenorenal shunts. Arch. Surg. (Chicago) 78: 774, 1959. Google Scholar19. GRACEMUENCHCHALMERS NDHTC: The present status of shunts for portal hypertension in cirrhosis. Gastroenterology 50: 684, 1966. CrossrefMedlineGoogle Scholar20. BYWATERS EG: Treatment of rheumatic fever. Circulation 14: 1153, 1956. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Internal Medicine Yale University School of Medicine New Haven, Conn. Veterans Administration Hospital West Haven, Conn. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byManagement of Esophageal Variceal BleedingPortal Hypertension and Portacaval Shunt**Supported by NIH Grants A3048, A5919, AM07315, AM07511, AM1228, AM19875, AM12280, AM17103, and DK41920.Prophylactic portacaval anastomosis in cirrhotic patients with esophageal varices and ascites 1 April 1969Volume 70, Issue 4Page: 859-864KeywordsHand strengthLiverPortal hypertension Issue Published: 1 April 1969 PDF downloadLoading ..." @default.
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