Evaluation of selective transsplenic decompression of gastroesophageal varices

Abstract A distal splenorenal shunt and selective gastric devascularization have been utilized in the management of gastroesophageal variceal bleeding in sixteen patients with portal hypertension. There was a single operative death in a patient with severe hepatic decompensation and uncontrollable bleeding. The three late deaths were not related to the operation or to liver failure. Neither variceal bleeding nor encephalopathy has occurred postoperatively. The data suggest that the concept that selective transsplenic decompression of gastroesophageal varices preserves hepatic portal flow and hepatic function is sound. The low morbidity and mortality suggest that further clinical use of this operative procedure is indicated.