Portal decompression in infants and children with the interposition mesocaval shunt

The mesocaval graft for portal decompression is applicable in infants and children with portal hypertension secondary to extrahepatic or intrahepatic causes. It is recommended in patients in whom extensive previous surgery in the portahepatis (Kasai procedure) would make dissection of the portal vein difficult and endanger the integrity of the functioning biliary conduit. It can be performed in patients who have had previous splenectomy or in whom portacaval or splenorenal shunts have failed. Autogenous jugular vein is favored for creation of the shunt.