Is There Still a Role for Surgical Shunts in the Treatment of Budd-Chiari Syndrome? A 25-Year Experience



To investigate the long-term results of shunt surgery in the treatment of Budd-Chiari Syndrome.


Medical records of patients treated with Budd-Chiari Syndrome between 1993 and 2006 were reviewed.


Thirty-seven patients (26 female, 11 male) were identified, with a median age of 30 years (range 14–51). Median duration of symptoms was 3 months (range 1 month to 10 years). Twenty-five patients, all in acute or subacute stages of disease, were treated surgically. Constructed shunts were mesoatrial in 17, portocaval in five (one was converted from a failed portorenal shunt) and mesocaval in three. Median portal pressure decreased from 44 cm H2O (range 31–55) to 20 cm H2O (range 5–27). Seven patients (28%) died in the perioperative period. Eighteen patients (72%) were followed up for a median of 186 months (24–241 months). Seven patients died during follow-up, five due to reasons related to the underlying cause and treatment. Remaining 11 patients (61%) were alive at a median of 18 years (13–25 years) with patent shunts. One-, 5-, and 10-year survival rates in patients undergoing shunt surgery were 78%, 72%, and 66%, respectively.


Portosystemic shunts may still be considered when expertise for transjugular intrahepatic portosystemic shunt or liver transplantation is not available.

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KRS, YT and AE equally worked for the design, acquisition and analysis of the data and revised the study critically. KRS drafted the work.

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Correspondence to Kursat Rahmi Serin.

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Serin, K.R., Tekant, Y. & Emre, A. Is There Still a Role for Surgical Shunts in the Treatment of Budd-Chiari Syndrome? A 25-Year Experience. J Gastrointest Surg 24, 1359–1365 (2020).

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  • Liver surgery
  • Portal hypertension
  • Surgical shunt