Gastric Varices: First You Have to See Them

59 decompression with small diameter PTFE interposi-tion grafts. The confirmation of Sarfeh's experience of durable patency with the use of small diameter ringed PTFE interposition prosthetic grafts appears to have allayed residual reservations about this procedure. Further experience over more extended periods will be required to establish whether it will truly match the excellent long term patency rate and functional results of the DSRS. In my view it has established a place in the operative therapeutic armamentarium for portal hy-pertension, especially for patients where a DSRS is impossible, for example patients who have undergone a,previous ill advised splenectomy. The technical simplicity and safety of this procedure are also appealing in the less common context of emergency shunting, although it is doubtful whether it will have a major impact on the much greater operative mortality experienced with all forms of emergency operative intervention in Childs grade C patients. 2. Johansen, K. (1992) Prospective comparison of partial versus total portal decompression for bleeding esophageal varices. Surg. Selective variceal decompression after splenectomy or splenic vein thrombosis with a note on splenopancreatic disconnection. Ann. Mesenteric venous stenosis reduces hyper-ammonemia in the portacaval shunted rat. To determine the prevalence and natural history of gastric varices, we prospectively studied 568 patients (393 bleeders and 175 nonbleeders) with portal hypertension (cirrhosis in 301 patients, noncirrhotic portal fibrosis in 115 patients, extrahepatic portal vein obstruction in 117 patients and hepatic venous outflow obstruction in 35 patients).