<prompt> According to pughs classification moderate to severe hepatic insufficiency is managed bySclerotherapyConservativeOhotopic liver transplantationShunt surgery  <response>: Patient of cirrhosis with variceal bleeding or ascites can be controlled by shunt surgery only if he falls in CTP class A or B Moderate to severe grade liver insufficiency can only be managed by liver transplantation Ref: Sabiston 20th edition Pgno : 1436 