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January 1967

Visceral Arterial Occlusion: Effects on Portal Venous Flow and Pressure

Author Affiliations

From the Department of Surgical Research, University of Rochester School of Medicine and Dentistry, Rochester.

Arch Surg. 1967;94(1):79-85. doi:10.1001/archsurg.1967.01330070081017

INTERRUPTION of the components of the visceral arterial circulation has been proposed as a method of reducing portal venous pressure and flow. The relationship between hepatic arterial pressure and portal venous pressure was initially evaluated by Herrick.1 He concluded that cirrhosis was characterized by intrahepatic anastomoses between the arterial and portal venous systems and that the pressure imparted to the portal venous system from the arterial circulation was responsible for the development of portal hypertension. McIndoe,2 however, was unable to confirm Herrick's work. The first clinical applications of ligation of vessels of the celiac axis as a method of reducing portal hypertension were carried out by Berman and associates and Reinhoff.3,4 While favorable results have been reported, the operation is generally held in disrepute.5,6 Physiologic determinations have failed to demonstrate any pressure changes within the portal venous system following ligation of the hepatic and splenic artery