The procedure converts the gastroesophageal-splenic portion of the portal system into a low-pressure system by providing a shunt to the systemic circulation via the renal vein; by preserving portal perfusion it reduces the hazard of liver failure associated with the portacaval shunt. It appears especially suitable for ascites-free cirrhotic patients who still have good liver function; the latter has been found to be unimpaired postoperatively.