[Postoperative syndromes after portacaval shunt in patients with cirrhosis of the liver (author's transl)].

Postoperative care of patients with a portacaval shunt is identical with the perioperative care performed to avoid the dangerous complications of cirrhosis of the liver. Clinical symptoms (edema, ascites, skin changes) and clinical chemistry (prothrombin time, bilirubin, albumin) will allow, to survey liver function appropriately. Neurological examination and simple psychosomatic tests (test of writing, trail making test) will allow to recognize early the occurrence of hepatoportal encephalopathy. EEG examinations done every 4 to 6 months are helpful in diagnosis. X-ray or endoscopic examinations should be done, if gastric ulcers are suspected. A definite warning must be pronounced against using high ceiling diuretics of unnecessarily; diuretics should be given only for short periods of time and in low dosage. Regular measurements of serum electrolytes are mandatory. The patient must be informed about the rationale of the diet restricted in proteins and abstinence from alcohol.