[Massive hemorrhage of the esophageal varix: standardized treatment and long-term results after portosystemic anastomosis (author's transl)].

A reexamination was conducted on 90 of 231 patients who had undergone portal-systemic shunt operations 2-15 years ago in our hospital due to massive esophageal varix bleeding. The results show that decompressing procedures represent the only therapeutic principle successfully preventing recurrence of massive esophageal hemorrhage over an extended period of time. Postoperative encephalopathy occurred relatively infrequently. This finding imposes considerably restraint on the use of this term as a weighty argument against portocaval shunts, especially because nitrogen substances are often known to pass unchanged from the intestinal tract to the vena cava and thus ultimately to the brain in patients with liver cirrhosis not undergoing surgery. The possibility of preventing recurrence of massive esophageal hemorrhage by protal decompression is meant to relieve the patient's constant fear of an incident putting his liver in jeopardy.