Transection Operations for Portal Hypertension

The treatment of bleeding from oesophageal varices has given rise to much discussion during the last decade and a half. There is now no doubt that a wide anastomosis between the portal vein and the inferior vena cava gives results which are much better than any other procedure as a means of reducing the danger of this haemorrhage. If the splenic vein is large an end-to-side splenorenal anastomosis holds out a good prospect of remaining patent, but the risk of its occlusion is greater than in the case of a portacaval anastomosis. Unfortunately there are many patients who bleed and in whom, for one reason or another, such a wide shunt is not feasible. Clatworthy and Boles (1959) have performed an anastomosis between the