ABSTRACT
Ten cases of portal hypertension were treated with selective distal spleno-caval shunt in the period from January 1984 to October 1985. The liver function was grade Ⅰ in 6 cases, grade Ⅱ in 2, and grade Ⅲ in the other 2. The operative procedure consisted of a direct end to side anastomosis between the distal part of the splenic vein and the inferior vena cava. There was no operative mortality. An average reduction of 4.4 cm of water of the portal pressure was obtained after the completion of the anastomosis. All the patients have been followed up for 3-24 months, and they are all doing very well and have resumed their original job fully or partially. Neither rebleeding nor hepatic encephalopathy occurred. The patency of the anastomosis was demonstrated by ultrasonography and angiography. The spleen was markedly shrinked in size and became softened.Ours is a new type of selective shunt. No report of such a kind of shunt has ever been published in the literature. It is recommended that this operation be used in the treatment of portal hyperension since it is effective.