<prompt> The operation that precipitates poosystemic encephalopathy isSplenorenul shuntSiguira operationTalma - Marison OperationPoacaval anastomosis  <response>: Poosystemic encephalopathy is a neuropsychiatric syndrome, It most often results from high gut protein or acute metabolic stress eg, GI bleeding, infection, electrolyte abnormality in a patient with poosystemic shunting. In poosystemic shunting, absorbed products that would otherwise be detoxified by the liver enter the systemic circulation and reach the brain, causing toxicity, paicularly to the cerebral coex. 