Initial experience with mesocaval H grafts: comparison with other portosystemic shunts.

Two policies concerning portosystemic shunt for bleeding esophageal varices were compared. In 18 patients, splenorenal or portocaval shunts were performed according to anatomic and hematologic considerations. In 13 patients, only mesocaval H grafts were performed. In the latter group, more patients had poor liver reserve and required urgent surgery. Accordingly, early and late mortality and morbidity were higher in these patients. the technical ease of performance of the mesocaval H graft did not cancel out increased risk in poorer candidates for surgery.