Outcome in cirrhotic patients with acute alcoholic hepatitis after emergency portacaval shunt for bleeding esophageal varices.

Operative liver biopsy findings were reviewed in 164 consecutive, unselected patients with alcoholic cirrhosis who had bleeding from esophageal varices and underwent emergency portacaval shunt. The survival rate up to 10 years in 49 patients with acute alcoholic hepatitis and alcoholic cirrhosis was not significantly different from that of patients with alcoholic cirrhosis alone. The two groups of patients were compared with respect to 35 other preoperative clinical and laboratory variables, and no other difference between the groups was found that obscured an adverse effect of acute alcoholic hepatitis on survival. We have concluded that acute alcoholic hepatitis and the presence of Mallory bodies in the liver are not a contraindication to portacaval shunt and that there is currently no demonstrated role for preoperative liver biopsy in the evaluation of patients with alcoholic cirrhosis and bleeding esophageal varices.