The authors report their experience of 30 mesenterico-caval anastomoses with prosthetic interposition according to Drapanas's technic. From the point of view of the operative indications, they have never carried out a prophylactic operation. In 19 cases, the operation was carried out as an emergency for inefficacy of the medical treatment. In 11 cases, a cold operation was performed, either to prevent eventual hemorrhagic recurrence (8 cases) or for chronic ascites (3 cases). Half the patients belonged to group C with a poor surgical risk. There was only one case of post-operative thrombosis due to a technical error, and two cases of secondary thrombosis. The overall mortality was 60%. But when the patient was of group A or B the mortality was only 20%. The survivors are those in whom the operation was rapid and the blood loss minimal. To conclude, the authors the necessity of better selection of patients, and rapid operation without bleeding.