Portosystemic Shunts

Portosystemic shunts can be classified as nonselective, selective, or partial (Table

Nonselective shunts are complicated by frequent (30-40%) postoperative en-cephalopathy and accelerated hepatic failure. The manifestations of encephalopathy include altered level of consciousness, intellectual decline, personality changes, tremor, and asterixis. The cause of encephalopathy may be attributed to toxins such as ammonia, mercaptans, and gamma-aminobutyric acid.

Treatment for hepatic encephalopathy may include lactulose and or oral neo-mycin.

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