title: [The meso-caval shunt--a future standard operation?].
abstract: As a result of several retrospective and prospective studies, there have been remarkable changes in surgery for portal hypertension, namely the limitation of surgical interventions to an asymptomatic time interval (without bleeding), and the preference for distal shunt operations, aiming at a lasting reduction of the portal hypertension with minimal reduction of portal liver perfusion. These requirements are best met by the mesocaval (H-) shunt, using a vascular prosthesis with sufficient wall stability and a negatively charged inner surface, such as, for example, the expanded PTFE graft (Gore-TEX). In contrast to several types of splenorenal shunt, the H-shunt in mesocaval position is characterized by the following advantages: (a) minimal operative stress, even in high-risk patients, (b) technical ease of use, (c) reduced operative mortality, especially for interval operations, (d) minimal risk of recurrent bleeding and encephalopathy. From this preliminary report it may be expected that the technique of mesocaval expanded PTFE shunt here presented is likely to become the method of choice in both elective and emergency interventions.
mesh_terms: D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D008638:Mesenteric Arteries / Q000601:surgery*; D008722:Methods; D010969:Plastics; D019736:Prostheses and Implants; D014682:Vena Cava, Inferior / Q000601:surgery*
chemical_list: D010969:Plastics
vernacular_title: Der meso-cavale Shunt--Standardoperation der Zukunft?