الفهرس 
REVIEW OF THE LITERATURE
Nonselective Portosystemic ShuntsOnly 14 pages are availabe for public view
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Abstract
Portal hypertension is a major cause of morbidity and mortality in cirrhotic patients Consequences of portal hypertension include ascites and esophageal varices which may result in life-threatening hemorrhage. Treatment of these conditions includes portal decompressive surgery either by creation of a portacaval shunt or, more recently, a transjugular intrahepatic portosystemic stent shunt (TIPS) It was suggested that surgical portal-systemic shunting worsens hepatic function because of the reduction of portal flow which, in turn, impairs the clearance of substances highly extracted by liver and reduces the amount of hepatotrophic factors carried to the hepatocytes by portal blood. Portal-systemic shunting plays an important role in the development of hepatic encephalopathy in cirrhotic patients with surgical or spontaneous portal-cava shunt . The complications of surgical and transjugular intrahepatic portosystemic shunts (TIPS) include liver failure due to decreased blood flow to the liver after reduction of portal hypertension and increased encephalopathy and massive bleeding in the context of impaired blood coagulation. Evaluations of cerebral function and morphology are useful for the determination of the pathophysiology of Portosystemic encephalopathy. Evaluations of cerebral function and morphology before and after shunt surgery and determination of the pathophysiology of Portosystemic encephalopathy using many variants of electroencephalogram-evoked responses and magnetic resonance spectroscopy.