<prompt> According to Pughs classification moderate to severe hepatic insufficiency is managed by -SclerotherapyConservativeOhotopic liver transplantationShunt surgery  <response>: Child-Pugh s classification is used to assess the status of pt. of liver cirrhosis. A liver cirrhotic pt. having variceal bleeding or ascites can be controlled by shunt surgery only if he falls in Child-Pughs A class or some pts. of B class. Moderate to severe grade liver insufficiency can only be managed by liver transplantation. Ref : CMDT, 2001, p 682 