A retrospective study of 43 patients who were operated on for portal hypertension was performed (29 distal splenorenal shunts, 7 total portosystemic shunts, five Sugiura's operations and 2 splenectomies with gastric devascularization). Eighteen patients had recurrence of hemorrhage, 10 had ascitis and six encephalopathy. Thirteen of the 43 patients (seven Warren's operations, five Sugiura's and one mesocaval shunt) received postoperative sclerotherapy. The overall operative mortality was 34.8%. In the period 1977-1982, six of 20 patients (30%) died, and in 1983-1988 nine of 23 died (39.1%) (p greater than 0.05); so, we concluded that we must improve the perioperative care and that this kind of operations must be performed only by experienced surgeons.