Mesentericocaval shunt (MCS) with autologous jugular vein

We report our personal experience of 114 patients with portal hypertension treated with mesentericocaval shunt (MCS) and 167 with portocaval anastomosis (PCA). In addition, the 2 procedures were evaluated in a controlled trial of 21 MCS patients and 25 PCA patients. We found no significant difference in the results of the 2 operations in terms of operative mortality rate, incidence of hepatic encephalopathy, and long‐term survival. The surgical procedure of MCS is no easier to perform than PCA; it requires the preparation of the graft, 2 vascular anastomoses, and longer operative time. It seems appropriate to select this operation only with those patients who, for anatomical reasons, cannot undergo PCA.