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Previous Volume 330:1827-1828 June 23, 1994 Number 25 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In his review of the care of patients with ascites (Feb. 3 issue),¹ Runyon downplays surgical treatments, such as peritoneovenous shunting. One option not mentioned is formal surgical portosystemic shunting, usually with an end-to-side portacaval shunt or a short, small-diameter H-graft reconstruction (a short interposition graft between the portal vein and vena cava). Both operations will reduce ascites and are analogous to the procedure used for transjugular intrahepatic portosystemic shunts. For patients with truly refractory ascites, in whom a peritoneal shunt is impossible, the risk of encephalopathy from a portosystemic shunt may be outweighed by the advantage . . . [Full Text of this Article]

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