PORTAL cirrhosis is progressively increasing, in importance as a medical and economic problem. The rising incidence of this disease at autopsy at the Los Angeles County Hospital is indicated in table 1. The reports of Whipple,1 Blakemore2 and Blalock3 on portacaval anastomosis have established the feasibility of surgical alleviation of certain of the distressing features exhibited by patients with advanced portal cirrhosis. The experience of my colleagues and me with the problem is presented in the following report of 14 cases, in 10 of which this operative procedure has been carried out. In all 10 cases the portal vein has been anastomosed to the inferior vena cava.
The portal system of veins is interposed between two capillary beds, that of the gastrointestinal tract, pancreas, spleen and gallbladder and that of the liver. Obstruction involving the capillaries of the bed of the liver or of the major vessels