Surgical treatment of Budd-Chiari syndrome SUN Yu-ling, XU Pei-qin. Department of General Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China Corresponding author: SUN Yu-ling, E-mail: ylsun@zzu.edu.cn Abstract Budd-Chiari syndrome (BCS) is a kind of retro-hepatic portal hypertension and surgical procedures are the main methods for its treatment. The choice of surgical procedures according to the clinical pathologic classification is the key for successful management. The new procedure of upper meso-caval shunt possesses higher operative successful rate and takes great advantages in the control of varied complications. The management of BCS complicated with hepatocellular carcinoma (HCC) should focus on HCC which determines the prognosis. Stage treatment will be better choice for subpopulation of BCS with the obstruction of IVC and HVs. Shunt combined with devascularization without splenectomy achieves satisfied results and it should re-evaluate the therapic indication for such BCS patients with complete compensation by intora-and extra-hepatic collateral circulations.