Total area of spontaneous portosystemic shunts independently predicts hepatic encephalopathy and mortality in liver cirrhosis

•Total cross-sectional SPSS area (TSA) predicts survival in patients with advanced chronic liver disease.•The cut-off for TSA that is associated with worse survival corresponds to a single shunt of >10 mm diameter.•This study may impact on the clinical use of TSA/SPSS for risk stratification and decision-making in the management of patients with cirrhosis. Background & AimsSpontaneous portosystemic shunts (SPSS) frequently develop in liver...