[Mesentericocaval shunt after esophageal bleeding in patients with cirrhosis of the liver; results during a 10 year period (author's transl)].

: 54 patients with cirrhosis of the liver and relapsing esophageal bleeding received mesentericocaval dacron shunts between 1st January 1975 and 31st December 1979 and were followed up to the end of 1980. Patients were accepted for surgery under the following conditions: (1) liver function had to be compensated, (2) there had to be no signs and symptoms of hepatoportal encephalopathy, (3) there had to be no signs and symptoms of activity of cirrhosis of the liver, (4) liver volume had to be between 1 000 and 2 500 ml, (5) portal vein perfusion had to be 15-35%, (6) stenosis of liver arteries had to be excluded. Lethality during the hospital period and from hepatoportal encephalopathy was 7.4%, late lethality was 11%; this accounted for a 5-year survival rate of 70%. Residual perfusion of the portal vein could be demonstrated in many cases by intra- and postoperative measurements with different methods. The dacron prosthesis was implanted into the superior mesenteric vein in an acute angle (it had a diameter of 16 mm). The prosthesis was occluded by thrombosis in 3 out of the first 18 cases operated upon. This could be prevented in the following 36 patients by intra- and postoperative longterm heparinisation.