Twenty-eight patients with portal hypertension were treated with splenectomy and end-to-side splenorenal shunt. Nineteen had cirrhosis and nine had portal vein thrombosis.
Among the patients with cirrhosis, there was one hospital death due to recurrent bleeding in a patient in whom shunt could not be constructed and only splenectomy was done. During the follow-up period, one patient developed encephalopathy and later died of liver failure. There were three additional deaths, one due to an unrelated cause and two due to liver failure. All the remaining patients are well and none has had recurrent bleeding.
All the patients with portal vein thrombosis survived the operation and are well. None has had recurrent bleeding. Encouraged by these results, we continue to use end-to-side splenorenal shunt in all patients except small children.