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Kurt W. Steegmüller, MD; Hans-Michael Märklin, MD; MAJ Harris W. Hollis, Jr, MC, USA

Arch Surg. 1984;119(3):269-273.

Abstract
• We studied the hemodynamics of hepatic blood flow before and after creation of portacaval shunts in 28 patients. Electromagnetic flow recordings were used to measure hepatic arterial flow (HAF) and portal venous flow (PVF) with respect to total hepatic blood flow (THBF). No correlation between PVF and portal pressure was found, but PVF was directly related to liver function. The concept that patients with low PVF tolerate shunts better (with respect to postoperative course and encephalopathy) than those with high PVF was not supported. Our investigations suggest the existence of a compensatory mechanism that tends to maintain THBF by increasing HAF following creation of a shunt. This compensatory increase occurs only in those patients with good liver function and normal or enlarged livers.

(Arch Surg 1984;119:269-273)

Author Affiliations
From the Departments of Surgery, Diakonissenkrankenhaus (Dr Steegmüller), Marienhospital (Dr Märklin), and Fifth General Hospital (Dr Hollis), Stuttgart, West Germany.

Footnotes
Accepted for publication Nov 15, 1983.

The opinions expressed herein reflect the personal views of the authors and are not necessarily those of the Department of Defense or the United States Army Medical Corps.

Reprint requests to Chirurgische Klinik Diakonissenkrankenhaus, Rosenbergstr 38, D-7000 Stuttgart 1, West Germany (Dr Steegmüller).

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