MESOCAVAL SHUNT IN TREATMENT OF REBLEEDING AFTER SPLENECTOMY FOR PORTAL HYPERTENSION

We performed end-to-side mesocaval shuntfor 20 portal hypertensive patients with rebleed-ing after splenectomy.The bleeding was imme-diately controlled in 7 treated by emergencymesocaval shunt.There was no operative death,and none of the patients developed encephalo-pathy.Follow-up from 4 months to 7 years re-vealed that 3 deaths were due to acute massivehemorrhage,hepatic failure and carcinoma ofthe stomach respectively.Two patients with re-bleeding treated by partial esophagogastrectomyare living and well.The conditions of the other15 patients are fairly good too.Our experienceshows that mesocaval shunt is effective in thetreatment of rebleeding in portal hypertensivepatients after splenectomy.But to further studythe hemodynamic changes and long-term re-sults,more patients and longer period of fol-low-up are required.