[Mesenterico-caval shunt with interposition of a prosthesis for intractable ascites caused by cirrhosis]

The interposition mesocaval shunt is followed both by a splancnic and sinusoidal decompression, being for this reason considered not only the most effective peripheral porto-systemic shunt, but also one of the indicated operations in the treatment of intractable cyrrhotic ascites. Intractable cyrrhotic ascites was the main indication in 9 cases with very different clinical pictures treated by the Author with mesocaval shunt, having observed no operative mortality and resulting a complete disappearance of ascites in 8 out of 9 cases and of the cohexistent idrothorax in one case. Angiographic pictures showed the patency of the shunt with constant demonstration, after few months, of a reversal portal blood flow (sometimes present before operation). This shunting procedure proved to be a very well tolerated operation with only a transient postoperative modification of liver function tests, excepted for one case in which the patient was lost after seven months because of hepatic encephalopaty with progressive liver failure.