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August 1954


Author Affiliations

Dr. Bernard Fisher is a John and Mary Markle Scholar.; From the Department of Surgery and the Addison H. Gibson Laboratory, University of Pittsburgh School of Medicine.

AMA Arch Surg. 1954;69(2):263-272. doi:10.1001/archsurg.1954.01270020129015

CLINICAL emphasis following ligation and shunting of major portions of the hepatic blood supply has been chiefly directed toward the effect upon portal hypertension, with little regard for the consequences on liver parenchyma. That this is so is strange in view of the fact that numerous investigators * have shown that experimental hepatic regeneration is intimately linked with the portal blood traversing this organ. Practically all have demonstrated that partial hepatectomy and a diverting or decreasing of the portal blood flow by means of an Eck fistula, side-to-side portacaval anastomosis, or obstruction of the portal vein leads to an inhibition of the complete regeneration that is seen in normal animals. Little or no experimental evidence has been presented to denote whether it is quantity of portal blood, a qualitative factor of it, or a combination of the two that provides the impetus to liver restoration.

Only recently has it been demonstrated

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