Clinical significance of portal systemic shunts in cirrhotic patients.

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"Portal vein shunt index, PVSI", "splenic vein shunt index, SPVSI" and "total shunt index, TSI" were measured in 72 cirrhotic patients quantatively using labelled macroaggregated albumin through a portal vein cathter and the relationship among these portal systemic shunts, prognosis, clinical sign and laboratory data was studied.<BR>PVSI showed a significant positive correlation with ICGR15 and prothrombin time and an inverse correlation with albumin. The history of ascites was more common in patients with high PVSI. There was a significant difference in survival rate between patients with PVSI below 40% and those with PVSI above 40%. There was also a significant difference in survival rate between patients with TSI below 40% and above 40%. Thus, PVSI and TSI will be a good marker of prognosis of cirrhotic patients.<BR>The size of esophageal varices and the risk of variceal bleeding increased with increasing of SPVSI. However, further increase above 50% or so of SPVSI decreased the size of varices and the risk of variceal bleeding.
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