[172 [238 [268 [269 [270 [271 [272 [273

difference between splenorenal and portacaval shunts. This impression was confirmed by a multivariant analysis reported by Lacaine and associates. Significantly, none of these reports classified patients on the basis of risk, and one suspects that better-risk patients are selected for splenorenal shunts because the procedure is more difficult and time consuming.

The early postoperative complications do not differ from those described for portacaval shunts, except wound infection and hydrothorax are both more common after splenorenal shunt, presumably in association with the thoracoabdominal incision. The important late complications are encephalopathy and recurrent bleeding. For the 10 series summarized in Table 26-5 , the incidence of encephalopathy among surgical

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