Selective distal splenorenal shunts. Technique and results.

Selective distal splenorenal shunt was successfully performed in 20 patients from October 1974 to August 1978. All of them had had gastrointestinal hemorrhage from gastroesophageal varices, diagnosed by barium swallow roentgenography or esophagogastroscopy. Only one patient underwent emergency surgery. Portal hypertension was due to hepatic schistosomiasis in 16 patients, and all underwent rectal biopsy and examination of stools to confirm the clinical diagnosis. A small group of patients had ascites, jaundice and hemorrhage. Hepatic encephalopathy has not been a problem, although the follow-up study is short.