MESOCAVAL SHUNT IN TREATMENT OF REBLEEDING AFTER SPLENECTOMY FOR PORTAL HYPERTENSION

We performed end-to-side mesocaval shunt for 20 portal hypertensive patients with rebleed- ing after splenectomy. The bleeding was imme- diately controlled in 7 treated by emergency mesocaval shunt. There was no o.perative death, and none of the patients developed encephalo- pathy. Follow-up from 4 months t0 7 years re- vealed that 3 deaths were due to acute massive hemorrhage, hepatic failure and carcinoma of the stomach respectively. Two patients with re- bleeding treated by partial esophagogastrectomy are living and well. The conditions of the other 15 patients are fairly good too. Our experience shows that mesocaval shunt is effective in the treatment of rebleeding in portal hypertensive patients after splenectomy. But to further study the hemodynamic changes and long-term re- suIts, more TPatients and longer period of fol- low-up are required.