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September 1950


Author Affiliations

With the Technical Assistance of Harriett L. Hills, A.B. SAN FRANCISCO
Clinical Instructor in Surgery, University of California School of Medicine.; Vascular Research Laboratory, Franklin Hospital.; From the Department of Surgery, University of Buffalo School of Medicine and the Edward J. Meyer Memorial Hospital.

Arch Surg. 1950;61(3):449-461. doi:10.1001/archsurg.1950.01250020454005

THE ESTABLISHMENT of experimental portacaval shunts by Nikolai V. Eck1 in 1877 laid the foundation for the consideration of the surgical correction of portal hypertension. According to Rosenstein,2 this was followed by the surgical thought and experimentation of Talma, Bier, Jersulem and Frank. Rosenstein2 and de Martel and Vidal3 completed portacaval anastomosis by the side to side technic early in the twentieth century. The work of Gad,4 Herrick,5 McIndoe,6 Burton-Opitz,7 Thomson,8 Barger and Dale,9 Whipple and his associates,10 Bayliss and Starling11 and others laid the groundwork for the understanding of hepatic metabolism and blood flow in cirrhosis and in the presence of an Eck fistula. Mclndoe6 demonstrated that the arterial bed of the liver seemed to be spared more than the portal in cirrhosis. With the improvement in vascular surgery and advance in physiology and diagnosis, there

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