Measurements of portal pressure and angiography were done to evaluate the hemodynamic changes after a distal splenocaval shunt (DSCS) in 25 patients with liver cirrhosis and portal hypertension. It was demonstrated that the portal pressure and portal perfusion were maintained in these patients in the early postshunting stage compared with the preshunting stage. Moreover, the diameter of the hepatic arteries increased following shunt, suggesting an increment in hepatic arterial flow. These hemodynamic effects probably contribute to the highly satisfactory outcomes in appropriately selected patients. The findings indicate that DSCS is effective and safe in the treatment of portal hypertension.