Selective coronary-caval shunt using internal jugular autograft, in the treatment of portal hypertension.

The selective coronary-caval shunt is considered to be one of the better procedures in the surgical treatment of portal hypertension. We have altered the previously described technique by using an internal jugular vein grafting which possesses some advantages. We have performed this shunt utilizing an internal jugular vein autograft in eight patients, who had at least one major hemorrhage from esophageal varices three to twelve months before operation. There were no postoperative deaths. All four patients are still alive three months to six years after shunting without bleeding episodes. In the X-ray and endoscopic studies the esophagogastric varices were noted to be markedly smaller in size than they were before shunting.