IT is important to have a method for making an objective evaluation of the patency of surgically created portal-systemic shunts. This is particularly true when bleeding or ascites occurs following apparent successful shunting procedures. Ideally, such a method should be atraumatic to the patient, inexpensive, and simple enough to be done on an outpatient basis so that repeated studies before and after shunting are feasible. We have found the oral fructose tolerance test as described by Kirsh et al,1 and Martin and Bryant2 to fulfill these criteria and to yield reliable information. The purpose of this paper is to report our experience with this test in 33 patients having portal hypertension secondary to liver disease or prehepatic portal vein obstruction. In an effort to increase accuracy, two-hour output of fructose in the urine was measured rather than just fructose concentration, as has been done in previous studies.
Rohrer GV, Welsh JD. Urinary Fructose Excretion After Fructose LoadingBefore and After Portal-Systemic Shunting. Arch Surg. 1968;96(6):979-982. doi:10.1001/archsurg.1968.01330240125030