Portopulmonary shunt by splenopneumopexy as a surgical treatment of Budd-Chiari syndrome.

Portopulmonary shunting by splenopneumopexy was devised as a new surgical procedure for treatment of portal hypertension accompanied by Budd-Chiari syndrome. Technique of this procedure is simple and is safely performed. The remarkable portopulmonary shunts were visualized by splenoportography postoperatively. Splenic pulp pressure was reduced to a postoperative mean value of 258.3 mm H2O from a preoperative mean value of 336.8 mm H2O. Hemorrhage from esophageal varices and ascites were well controlled after operation. Postoperative liver function tests were essentially unchanged from the preoperative values. Any respiratory and circulatory complications after this shunting have not been observed so far. It is concluded that portopulmonary shunt by splenopneumopexy is an effective procedure for portal hypertension caused by Budd-Chiari syndrome.