Experience with Portacaval Shunt for Portal Hypertension

SINCE the beginning of our experience with the surgical treatment of portal hypertension, we have believed that the operation of choice is portacaval shunt and that splenorenal shunts, because they are small and so frequently inadequate, should be restricted to patients with portal veins unsuitable for anastomosis to the inferior vena cava.§ There is abundant evidence that such a procedure is followed by the disappearance of esophagogastric varices and therefore the elimination of the hazards of massive varical hemorrhage. Although this is a laudable surgical achievement, critical analysis suggests that the problem of portal hypertension is not as simple as . . .