Operative results in portal hypertension with bleeding oesophageal varices

During a 15-year period 81 patients with bleeding oesophageal varices were admitted to our department. Nearly 90% had liver cirrhosis, 21% were alcoholics. 67 portosystemic shunts were performed in 63 patients, in 11 of these as an emergency shunt. Overall operative mortality in electively shunted patients was 10.7%. Even in those with the most severe liver insufficiency (Child's group C) operative mortality was below 20%. Operative mortality in elective cases was closely correlated to peroperative bleeding. Only 1 of 45 patients needing less than 10 units of blood peroperatively died, while mortality in the multitransfused group was 45.5%. Both patients surviving urgent shunt surgery were operated on early, i.e. before they had received 5 units of blood.