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Use of the Autogenous Jugular Vein for Interposition Grafting in Portal Hypertension

Relief of portal hypertension has been achieved in both man and animals by the use of the autogenous jugular vein for interposition grafting. During the past two years, we have treated eight men with bleeding varices by this technic. They underwent portosystemic interposition of the autogenous internal jugular vein by “H” grafting, either as an emergency procedure or as elective surgery. One patient died shortly after surgery, and a second died four months postoperatively. Examination at autopsy showed both grafts to be open. Three other patients had splenoportograms showing open balanced shunts. Three more had no further hemorrhage. None of the surviving patients had evidence of hepatic encephalopathy. The fact that six-eighths of these poor-risk patients have survived, along with the high patency rate of the grafts, suggest that this surgical technic warrants further application.