Total portacaval shunts

The relative polarization of surgical camps regarding the most appropriate surgical approach to portal decompression and the development of hepatic transplantation and transjugular intrahepatic portosystemic shunting has kept interest in this field of study alive and evolving. This chapter outlines the indications for a total shunt, the preoperative evaluation and preparation of the patient with cirrhosis who has portal hypertension, operative techniques, complications, and outcomes for these operations.