WITH the improvement and refinement of the technic of portacaval anastomosis by Whipple1 and Blakemore and Lord,2 an important addition was made to the armamentarium of the surgeon in his approach to the difficult problem of portal hypertension. In the past year Blakemore3 has reported 14 cases of portacaval shunt performed for the alleviation of portal hypertension. In this series there were 2 operative deaths. One patient died one year postoperatively, and another succumbed two years and three months after operation. Although the follow-up of the surviving patients was of necessity short, this operative procedure appears to offer the greatest promise at the present time for relief of the distressing effects of portal hypertension.
It is, however, an operation of considerable magnitude. It requires hours for its satisfactory completion and places a tremendous additional load on an already overtaxed patient. Because of these facts, there will be