Abstract THE HEPATIC artery contributes about 20% of hepatic blood flow, while the portal vein carries the remaining 80%. There is some collateral supply, but under normal conditions this is negligible. Reciprocal variations in the amount of blood carried by either the hepatic artery or the portal vein occur, and Soskin and co-workers1 have observed that this reciprocal variation could be as low as 10% or as high as 90% in either vessel. Some interesting observations have been made when the liver is supplied by either one of these vessels, the other being tied. Ligation of the portal vein, as in Eck fistula, results in parenchymal fibrosis and considerable reduction in the size of the liver. The dogs, however, do not die, and there is little or no alteration in hepatic function.2 Ligation of all the branches of the hepatic artery is followed in about 100% of cases by References 1. Soskin, S.; Essex, H. E.; Herrick, J. F., and Mann. F. C.: The Mechanism of Regulation of the Blood Sugar by the Liver , Am. J. Physiol. 124:558, 1938. 2. Mann, F. C., and Bollman, J. L.: Liver Function Tests , Arch. Path. & Lab. Med 1:681, 1926. 3. (a) Haberer, H.: Experimentelle Unterbindung der Leberarterie , Arch. klin. Chir 78:557, 1905. 4. (b) Harrison, G. A.: Chemical Methods in Clinical Medicine: Their Application and Interpretation with the Technique of the Simple Tests , Ed. 2, London, J. & A. Churchill, Ltd., 1937. 5. (c) Huggins, C., and Post, J.: Experimental Subtotal Ligation of the Arteries Supplying the Liver , Arch. Surg. 35:1165, 1937. 6. (d) Narath, A.: Über Entstehung der anämischen Lebernekrose nach Unterbindung der Arteria hepatica und ihre Verhütung durch arterio-portale Anastomose , Deutsche Ztschr. Chir. 135:375, 1916. 7. (a) Fraser, D.; Rappaport, A. M.; Vuylsteke, C. A., and Colwell, A. R.: The Effects of the Ligation of the Hepatic Artery in the Dog , Surgery 30:624, 1951. 8. (b) Grindlay, J. H.; Mann, F. C., and Bollman, J. L.: Effect of Occlusion of the Arterial Blood Supply to the Normal Liver: Experimental Study , A. M. A. Arch. Surg. 62:806, 1951. 9. (c) Markowitz, J.; Rappaport, A. M., and Scott, A. C.: The Function of the Hepatic Artery in the Dog , Am. J. Digest. Dis. 16:344, 1949 10. (d) Prevention of Liver Necrosis Following Ligation of the Hepatic Artery , Proc. Soc. Exper. Biol. & Med. 70:305, 1949. 11. (e) Markowitz, J., and Rappaport, A. M.: The Hepatic Artery , Physiol. Rev. 31:188, 1951. 12. (f) Tanturi, C.; Swigart, L. L., and Canepa, J. F.: Prevention of Death from Experimental Ligation of the Liver (Hepatic Proper) Branches of the Hepatic Artery , Surg., Gynec. & Obst. 91:680, 1950. 13. Ellis, J. C.; and Dragstedt, L. R.: Liver Autolysis in Vivo , Arch. Surg. 20:8, 1930. 14. Graham, R. R., and Cannell, D.: Accidental Ligation of the Hepatic Artery: Report of One Case, with Review of Cases in Literature , Brit. J. Surg. 20:566, 1933. 15. MacLennan, J. D., and MacFarlane, R. G.: Toxin Antitoxin Studies of Gas-Gangrene in Man , Lancet 249:301, 1945. 16. Bollman, J. L.: The Influence of Diet on the Production of Ascites , Arch. Path. 6:162, 1928. 17. (a) Benedict, S. R.: The Detection and Estimation of Glucose in Urine , J. A. M. A. 57:1193, 1911. 18. (b) Esbach, H.: Urine Protein , in Hawk, P. B.; Oser, B. R., and Summerson, W. H.: Practical Physiological Chemistry , Philadelphia, The Blakiston Company, 1947, p. 868. 19. (c) Malloy, H. T., and Evelyn, K. A.: The Determination of Bilirubin with the Photoelectric Colorimeter , J. Biol. Chem. 119:481, 1937. 20. (d) Nelson, N.: A Photometric Adaptation of the Somogyi Method for the Determination of Glucose , J. Biol. Chem. 153:375, 1944. 21. (e) Somogyi, M.: A New Reagent for the Determination of Sugars , J. Biol. Chem. 160:61, 1945. 22. (f) Rosenthal, S. M., and White, E. C.: Clinical Application of the Bromsulphalein Test for Hepatic Function , J. A. M. A. 84:1112, 1925. 23. (g) Schiff, L.: The Differential Diagnosis of Jaundice . Chicago, The Year Book Publishers, Inc., 1946. 24. Hoffman, W. S.: Subcutaneous Versus Intramuscular Administration of Penicillin , J. Lab. & Clin. Med. 31:1165, 1946. 25. Ungar, J.: Penicillin in Tissue Exudates After Injection , Lancet 1:56, 1950.
A.M.A. Archives Surgery – American Medical Association
Published: Nov 1, 1952
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