Interposition left gastric-caval shunt using internal jugular vein autograft in the treatment of portal hypertension.

The selective left gastric-caval shunt is, in theory, one of the better procedures in the surgical treatment of portal hypertension. We have performed a modification of the previously described technique utilizing an internal jugular vein autograft in 4 patients who had had more than one major haemorrhage from oesophageal varices 3-12 months before operation. There were no post-operative deaths. All 4 patients are still alive 3 months to 4 years after shunting, with no episodes of bleeding. On radiological and endoscopic follow-up, the oesophagogastric varices were noted to be markedly smaller in size than before shunting.