Data on 231 patients with esophageal varices and portal hypertension secondary to intrahepatic block who underwent a left gastric venous caval shunt are presented herein. Operative death occurred in 5 (2.2%) and late death in 80 (34.6%), resulting in 146 survivors at a mean follow-up period of 66 months. Postoperative variceal bleeding occurred in 17 (7.4%). Five-year survival rate was 69.8% overall, and 62.0% in patients with cirrhosis. Eck's syndrome occurred in none, and a prograde portal flow was preserved in all 43 patients who were examined angiographically or ultrasonically. Left gastric venous caval shunt is a safe and effective surgical treatment which provides less insult to portal hemodynamics for a long postoperative period of time.
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