The distal splenorenal shunt in patients with variceal bleeding due to schistosomal hepatic fibrosis.

Twenty consecutive patients classified as Child's A and B with variceal bleeding from schistosomal hepatic fibrosis were electively managed by the distal splenorenal shunt. Patients were assessed clinically by angiography and were observed for up to 16 months. The over-all survival rate was 85 per cent with an operative mortality rate of 10 per cent. All of the patients had patent shunts as confirmed angiographically and all maintained hepatic perfusion; there was also a 40 per cent immediate reduction in the size of the spleen postoperatively as measured on the angiograms. None of the patients had encephalopathy and only two patients had postoperative ascites.