Some reflections about portosystemic shunt in portal hypertension

The authors report on the group of 85 patients with portal hypertension in whom a portosystemic shunt was established for uncontrolled bleeding from varices--in the period from 1968 to 1993. A total lethality was 9.4%, in planned operations 5.9%, in acute interventions 22%. Some aspects of shunt-operation are discussed (prehepatic portal hypertension, acute shunt, shunt preceding liver transplantation). It is concluded that the portosystemic shunt still plays a role in the therapy of complicated portal hypertension, although only as a selective intervention.