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Original Contributions
March 28, 1964

Control of Fibrinolysis During Portacaval ShuntsStudy of Patients With Cirrhosis of the Liver

JAMA. 1964;187(13):1005-1008. doi:10.1001/jama.1964.03060260033007

In a series of 240 patients with cirrhosis of the liver, surgery for correction of portal hypertension was done in 102 who had bled from esophageal varices or had intractable ascites. Uncontrollable oozing developed during surgery in 13, all of whom had hypofibrinogenemia and high fibrinolytic activity of the plasma. Intravenous use of e-aminocaproic acid resulted in arrest of oozing and permitted completion of surgery in 11 patients. The fibrinolytic inhibitor was used successfully also to control postoperative bleeding from unusual sites. Evaluation of coagulation factors is recommended in patients with chronic liver disease undergoing surgery.