The ideal test for determining patency of a portacaval shunt would be applicable to all patients, simple to perform, give accurate, consistent results which are easy to interpret, and afford minimal risk to the patient. Many techniques have been utilized which have met these criteria with varying degrees of success.
The direct approach has been the actual visualization of the portal vein by splenoportography or retrograde catheterization of the portal vein via the inferior vena cava. These procedures are not without hazard and require considerable experience to be performed properly.
Measurement of portal circulation time by rectal instillation of ether1 or radioactive sodium,2 or by intravenous injection of labelled isotopes3 or radioactive gases4 have been proposed as methods of determining shunt patency. The end-point obtained by these techniques is vague, however. Consequently there has been a wide variation in results.
The bypassed liver is unable to
KIRSH MM, CARES H, ZUIDEMA GD. Evaluation of the Oral Fructose TestIts Use in Determining Patency of Portacaval Shunts. Arch Surg. 1964;89(3):508-511. doi:10.1001/archsurg.1964.01320030098016