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J. R. GUTELIUS, MD; H. M. SHIZGAL, MD

AMA Arch Surg. 1966;93(5):755-758.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CANNULATION of the cervical thoracic duct and external lymphatic drainage has been observed, by Dumont,¹ to lead to a reduction in portal pressure and ascites in the cirrhotic patient. The physiological basis for this response has not been clarified.

A functional resistance at the venolymphatic area is an attractive concept which has received some support from previous investigation. Zemel and Gutelius² have observed a valve structure at the junction that might limit a potential increase in lymphatic flow. The reduction in ascites following thoracic duct-esophageal shunting of lymph also supports the presence of a significant resistance at the junction.³ If a mechanical factor limiting flow at the lymphatic venous junction can be confirmed, a permanent reduction of portal pressure might result from thoracic duct venous anastomosis.⁴ Therefore, the present study was undertaken to evaluate resistance at the lymphatic venous junction at normal and elevated flow rates. . . . [Full Text PDF of this Article]

Author Affiliations
MONTREAL

From the Department of Surgery, Royal Victoria Hospital and McGill University, Montreal.

Footnotes
Read before the 14th Scientific Meeting of the North American Chapter of the International Cardiovascular Society, Chicago, June 25, 1966.

Reprint requests to Department of Surgery, Royal Victoria Hospital, Montreal 2, Quebec, Canada (Dr. Gutelius).

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