Reoperation of postoperative rebleeding in patients with portal hypertension

Since 1970, reoperation was performed on 84 cases with postoperative rebleeding gastroesophageal varices. The operative mortality was 15.5%. Of the 71 patients discharged from the hospital 67 were followed up. The five year survival rate after the operation was 66.1%. Seven of 43 cases treated by portoazygos disconnection died of bleeding varices after the surgery. Among the 32 cases undergoing portal systemic shunt, one died of rebleeding. Shunt operation plus portoazygos disconnection was performed on 5 cases without postoperative rebleeding death. Three of four patients treated by incomplete portoazygos disconnection died of postoperative rebleeding. Our results showed that shunt operation alone or added with portoazygos disconnection have the advantage over portoazygos disconnection in preventing postoperative bleeding, and should be the procedure of choice in treating rebleeding patients.