Portal hypertension and bleeding esophageal and gastric varices: a surgical approach to treatment.

Ascites, hepatic encephalopathy, and bleeding esophageal and gastric varices are frequent consequences of hepatic disease and portal hypertension. Variceal bleeding, however, is the most dangerous sequel and the most yielding to surgical intervention. Portal decompression by the shunting procedure is instituted in order to decrease the risk of future gastrointestinal hemorrhage. The presence of hepatic disease and alterations in hepatic blood flow following the procedure present implications for postoperative management of fluid and electrolyte balance, mental status, ventilation, and coagulation.