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The small-diameter portacaval H-graft has been shown to be a reliable method of controlling variceal hemorrhage. However, little has been written about the long-term follow-up of poor-risk patients treated by this method. Over the last 11 years, we have performed 38 portacaval H-grafts; 79% of the patients were Child's B or C, and 79% were alcoholic. The mean age was 52 years, and the mean period of follow-up was 44 months. Over 37% of the grafts were performed in patients who were bleeding at the time of operation. Our 30-day operative mortality was 13%. Postoperatively, the small-diameter H-graft was associated with mild to moderate encephalopathy in 33% of the patients and ascites in 42%. Both these conditions were easily controlled with diet and medication. Early recurrent variceal bleeding was seen in 13% of patients. However, on late follow-up, recurrent hemorrhage and encephalopathy have been seen in only 12% and 14% of patients, respectively. We conclude that the portacaval H-graft is a reliable and lasting method for controlling variceal bleeding with an acceptable postoperative morbidity and mortality.
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**Presented at the 20th Annual Meeting of the Society for ClinicalVascular Surgery, Orlando, Florida, March 25–29, 1992.
© 1992 Reed Publishing USA. Published by Elsevier Inc.