Arch Surg 1985 Jun;120(6):657-62

The Budd-Chiari syndrome. Medical and surgical management of 30 patients

McCarthy PM, van Heerden JA, Adson MA, Schafer LW, Wiesner RH

Abstract
A retrospective review of 30 patients with documented Budd-Chiari syndrome
disclosed an overall mortality of 57%. Medical treatment alone was associated
with an 86% mortality; hepatic failure was the most common cause of death.
Mortality was 31% overall for the surgical group, but there were long-term
survivors among patients undergoing portacaval shunting. From this series, no
single surgical procedure was found to be clearly superior. Surgical treatment
with a side-to-side portacaval shunt seems to be the preferred operation when it
can be performed. Surgical intervention should proceed soon after the diagnosis
is made, lest extension of thrombus occur. Medical therapy most often is
ineffective