The management of bleeding oesophageal varices is the milestone in the management of portal hypertension with its different causes. We have demonstrated the recent advances in pharmacological, radiological, and endoscopic modalities in the management of bleeding oesophageal varices. Surgery has become a second line in the management of bleeding oesophageal varices after the progress in pharmacotherapy and endoscopic therapy. Shunt operations are the standard way to control bleeding varices in Child A prehepatic and hepatic causes of portal hypertension. In this Thesis, we have demonstrated the effects and benefits of a new highly selective shunt in the management of bleeding oesophageal varices in Child A prehepatic and hepatic causes of portal hypertension. This Thesis proves the great success of this new shunt operation in controlling bleeding oesophageal varices with almost no incidence of encephalopathy or rebleeding. Special attention was given to discuss liver transplantation being the treatment of choice for patients with end-stage liver disease and the complication of such disease, which include oesophageal varices, encephalopathy, ascites, fatigue, and muscle wasting.