Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

HEPATIC, SPLENIC, AND LEFT GASTRIC ARTERIAL LIGATIONS IN ADVANCED PORTAL CIRRHOSIS

HEPATIC, SPLENIC, AND LEFT GASTRIC ARTERIAL LIGATIONS IN ADVANCED PORTAL CIRRHOSIS Abstract IN MARCH, 1947, one of us (J. K. B.) began investigating the effects of hepatic and splenic artery ligations on portal pressures in normal and in portal hypertensive dogs. Summaries of this work have been presented,1 and a report of our first case2 has been published. This paper is an account of our first 12 cases with advanced portal cirrhosis of the liver treated by hepatic, splenic, and left gastric arterial ligations. INDICATIONS AND CONTRAINDICATIONS These patients were operated upon because they were cirrhotics who did not respond to medical management, including use of cation-anion resins, and who, in addition, had symptoms and signs which are known to indicate a poor prognosis if allowed to persist or progress. The symptoms and signs in the order of their gravity were (1) rapid regression in the size of the liver; (2) bleeding varices or bleeding from the gastrointestinal tract; (3) References 1. (a) Berman, J. K.; Koenig, H., and Saint, W. K.: Ligation of the Hepatic and Splenic Arteries in the Treatment of Portal Hypertension , Indiana Univ. Quart. Bull. 12:99, 1950. 2. (b) Berman, J. K., in discussion on Grindlay, J. H.; Mann, F. C., and Bollman, J. L.: Effect of Occlusion of the Arterial Blood Supply to the Normal Liver: An Experimental Study , A. M. A. Arch. Surg. 62:806, 1951.Crossref 3. (a) Berman, J. K.; Muller, L. P.; Fisch, C., and Martz, W.: Ligation of the Hepatic and Splenic Arteries in a Patient with Atrophic Cirrhosis of the Liver , A. M. A. Arch. Surg. 63:623, 1951.Crossref 4. (b) Berman, J. K.; Koenig, and Muller, L.: Ligation of the Hepatic and Splenic Arteries in the Treatment of Portal Hypertension: Ligation in Atrophic Cirrhosis of the Liver , A. M. A. Arch. Surg. 63:379, 1951.Crossref 5. Moser, R. H.; Rosenak, B. D.; Pickett, R. D., and McIntire, C. R.: The Prognosis of Portal Cirrhosis: An Analysis of 62 Cases , Gastroenterology 18:86, 1951. 6. Ratnoff, O. D., and Patek, A. J., Jr.: The Natural History of Laennec's Cirrhosis of the Liver: An Analysis of 386 Cases , Medicine 21:207, 1942. 7. Patton, T. B., and Johnston, G. G.: A Method for Control of Bleeding from Esophageal Varices , Arch. Surg. 59:502, 1949.Crossref 8. Sengstaken, R. W., and Blakemore, A. H.: Balloon Tamponage for the Control of Hemorrhage from Esophageal Varices , Ann. Surg. 131:781, 1950.Crossref 9. Whitby, L. E. H., and Britton, C. J. C.: Disorders of the Blood , Ed. 5, Philadelphia, The Blakiston Company, 1946. 10. DeTakats, G.: Personal communication to the authors. 11. Markowitz, J.; Rappaport, A., and Scott, A. C.: Prevention of Liver Necrosis Following Ligation of Hepatic Artery , Proc. Soc. Exper. Biol. & Med. 70:305, 1949. 12. Berman.1a Ratnoff.4 13. (a) Altemeier, W. A.: Personal communication to the authors. 14. (b) Reynolds, J.: Personal communication to the authors. 15. (c) Swan, H.: Personal communication to the authors. 16. (d) Benson, C.: Personal communication to the authors. 17. (e) Rienhoff, W. F.: Ligation of the Hepatic and Splenic Arteries in the Treatment of Portal Hypertension with a Report on 6 Cases , Bull. Johns Hopkins Hosp. 88:368, 1941. 18. Preshaw, D. E.; Large, A., and Johnson, A. F.: Effect of Portacaval Venous Shunt on Sulfobromophthalein (Bromsulphalein®) Retention , A. M. A. Arch. Surg. 62:801, 1951. 19. Bradley, S. E.; Ingelfinger, F. J.; Bradley, G. P., and Curry, J. J.: The Estimation of Hepatic Blood Flow in Man , J. Clin. Invest. 24:890, 1945. 20. Bradley, S. E.: Variations in Hepatic Blood Flow in Man During Health and Disease , New England J. Med. 240:456, 1951. 21. Habif, D. V.; Papper, E. M.; Fitzpatrick, H. F.; Lowrance, P.; Smythe, C. McC., and Bradley, S. E.: The Renal and Hepatic Blood Flow, Glomerular Filtration Rate and Urinary Output of Electrolytes During Cyclopropane, Ether, and Thiopental Anesthesia, Operation and the Immediate Postoperative Period , Surgery 30:241, 1951. 22. Berman, J. K., and Hull, J. E.: Circulation in the Normal and Cirrhotic Liver, Ann. Surg., to be published. 23. Grindlay, J. H.; Mann, F. C., and Bollman, J. C.: Discussion Before the Central Surgical Association, Chicago, Feb. 23, 1951. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

HEPATIC, SPLENIC, AND LEFT GASTRIC ARTERIAL LIGATIONS IN ADVANCED PORTAL CIRRHOSIS

A.M.A. Archives Surgery , Volume 65 (1) – Jul 1, 1952

Loading next page...
 
/lp/american-medical-association/hepatic-splenic-and-left-gastric-arterial-ligations-in-advanced-portal-00hbG0QK7J
Publisher
American Medical Association
Copyright
Copyright © 1952 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1952.01260020049005
Publisher site
See Article on Publisher Site

Abstract

Abstract IN MARCH, 1947, one of us (J. K. B.) began investigating the effects of hepatic and splenic artery ligations on portal pressures in normal and in portal hypertensive dogs. Summaries of this work have been presented,1 and a report of our first case2 has been published. This paper is an account of our first 12 cases with advanced portal cirrhosis of the liver treated by hepatic, splenic, and left gastric arterial ligations. INDICATIONS AND CONTRAINDICATIONS These patients were operated upon because they were cirrhotics who did not respond to medical management, including use of cation-anion resins, and who, in addition, had symptoms and signs which are known to indicate a poor prognosis if allowed to persist or progress. The symptoms and signs in the order of their gravity were (1) rapid regression in the size of the liver; (2) bleeding varices or bleeding from the gastrointestinal tract; (3) References 1. (a) Berman, J. K.; Koenig, H., and Saint, W. K.: Ligation of the Hepatic and Splenic Arteries in the Treatment of Portal Hypertension , Indiana Univ. Quart. Bull. 12:99, 1950. 2. (b) Berman, J. K., in discussion on Grindlay, J. H.; Mann, F. C., and Bollman, J. L.: Effect of Occlusion of the Arterial Blood Supply to the Normal Liver: An Experimental Study , A. M. A. Arch. Surg. 62:806, 1951.Crossref 3. (a) Berman, J. K.; Muller, L. P.; Fisch, C., and Martz, W.: Ligation of the Hepatic and Splenic Arteries in a Patient with Atrophic Cirrhosis of the Liver , A. M. A. Arch. Surg. 63:623, 1951.Crossref 4. (b) Berman, J. K.; Koenig, and Muller, L.: Ligation of the Hepatic and Splenic Arteries in the Treatment of Portal Hypertension: Ligation in Atrophic Cirrhosis of the Liver , A. M. A. Arch. Surg. 63:379, 1951.Crossref 5. Moser, R. H.; Rosenak, B. D.; Pickett, R. D., and McIntire, C. R.: The Prognosis of Portal Cirrhosis: An Analysis of 62 Cases , Gastroenterology 18:86, 1951. 6. Ratnoff, O. D., and Patek, A. J., Jr.: The Natural History of Laennec's Cirrhosis of the Liver: An Analysis of 386 Cases , Medicine 21:207, 1942. 7. Patton, T. B., and Johnston, G. G.: A Method for Control of Bleeding from Esophageal Varices , Arch. Surg. 59:502, 1949.Crossref 8. Sengstaken, R. W., and Blakemore, A. H.: Balloon Tamponage for the Control of Hemorrhage from Esophageal Varices , Ann. Surg. 131:781, 1950.Crossref 9. Whitby, L. E. H., and Britton, C. J. C.: Disorders of the Blood , Ed. 5, Philadelphia, The Blakiston Company, 1946. 10. DeTakats, G.: Personal communication to the authors. 11. Markowitz, J.; Rappaport, A., and Scott, A. C.: Prevention of Liver Necrosis Following Ligation of Hepatic Artery , Proc. Soc. Exper. Biol. & Med. 70:305, 1949. 12. Berman.1a Ratnoff.4 13. (a) Altemeier, W. A.: Personal communication to the authors. 14. (b) Reynolds, J.: Personal communication to the authors. 15. (c) Swan, H.: Personal communication to the authors. 16. (d) Benson, C.: Personal communication to the authors. 17. (e) Rienhoff, W. F.: Ligation of the Hepatic and Splenic Arteries in the Treatment of Portal Hypertension with a Report on 6 Cases , Bull. Johns Hopkins Hosp. 88:368, 1941. 18. Preshaw, D. E.; Large, A., and Johnson, A. F.: Effect of Portacaval Venous Shunt on Sulfobromophthalein (Bromsulphalein®) Retention , A. M. A. Arch. Surg. 62:801, 1951. 19. Bradley, S. E.; Ingelfinger, F. J.; Bradley, G. P., and Curry, J. J.: The Estimation of Hepatic Blood Flow in Man , J. Clin. Invest. 24:890, 1945. 20. Bradley, S. E.: Variations in Hepatic Blood Flow in Man During Health and Disease , New England J. Med. 240:456, 1951. 21. Habif, D. V.; Papper, E. M.; Fitzpatrick, H. F.; Lowrance, P.; Smythe, C. McC., and Bradley, S. E.: The Renal and Hepatic Blood Flow, Glomerular Filtration Rate and Urinary Output of Electrolytes During Cyclopropane, Ether, and Thiopental Anesthesia, Operation and the Immediate Postoperative Period , Surgery 30:241, 1951. 22. Berman, J. K., and Hull, J. E.: Circulation in the Normal and Cirrhotic Liver, Ann. Surg., to be published. 23. Grindlay, J. H.; Mann, F. C., and Bollman, J. C.: Discussion Before the Central Surgical Association, Chicago, Feb. 23, 1951.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Jul 1, 1952

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$499/year

Save searches from
Google Scholar,
PubMed

Create folders to
organize your research

Export folders, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month