hepatoportal sclerosis or idiopathic portal hypertension has a worldwide distribution with prevalence in developing and temperate countries. of 64 patients with this disease seen during a twelve year period, 36 underwent splenectomy or a shunt procedure. the indications for surgical intervention were severe hypersplenism and persistent left upper abdominal pain andlorhistory of frequent episode...

Hepatic cholesterol synthesis. hepatic cyclic AMP, and portal and peripheral insulin and glucagon levels were investigated in nine dogs and three baboons after complete portacaval shunt. Cholesterol synthesis as measured with acetate incorporation was reduced in both species, Hepatic cyclic AMP increased in dogs, Changes in portal and systemic insulin were inconsistent. but hyperglucagonemia oc...

Two patients are described with chronic liver disease and portal hypertension in association with ulcerative colitis for which colectomy and ileostomy had been performed. Both patients developed bleeding from the varices situated around the ileostomy stoma and one also bled from the oesophageal varices. Each had a successful portacaval shunt performed because of this bleeding. The occurrence of...

Cirrhotic or hepatic myelopathy is a rare neurological complication of chronic liver disease usually seen in adults and presents as a progressive pure motor spastic paraparesis which is usually associated with overt liver failure and a surgical or spontaneous systemic portocaval shunt. We describe the development of progressive spastic paraparesis, in a patient with alcoholic cirrhosis with por...

We present the case of a 24-year-old man who was incidentally diagnosed with congenital extrahepatic portosystemic shunt with portal vein aneurysm during an investigation for non-specific abdominal pain. These are rare anomalies, and to the best of our knowledge, this is the first case reported with both anomalies associated together. Ultrasound, including color Doppler, computed tomography, an...

Since the isotopes can not be utilized for veterinary patients in Japan, the authors developed a simple calculation formula of shunt fraction of portosystemic shunt based on the hepatic circulation model. The shunt fraction can be calculated utilizing only 2 portal pressure measurements of pre-shunt ligation and temporary or permanent shunt ligation. The calculated shunt fraction can obtained p...

The management of children with portal hypertension has dramatically changed during the past decade, with an improvement in outcome. This has been achieved by improved efficiency of endoscopic variceal control and the success of liver transplantation. Emergency surgical shunt procedures are rarely required, with acute bleeding episodes generally controlled endoscopically or, occasionally in adu...

At pancreatic ductal adenocarcinoma is an aggressive malignancy with a high recurrence rate. Due to its high potentials of local invasion and distant metastasis, surgical resection is the only means for possible long-term survival. Surgical treatment comprises a distal pancreatectomy with or without splenectomy. Surgery has been conventionally contraindicated for patients with cirrhosis and por...

Surgery for portal hypertension began in 1877, with Nicolai Vladirmirovich who performed the fi rst portacaval anastomosis. There was little clinical success until Blakemore and Whipple between the 1920’s and 1940’s: the mortality rate ranged from 25-40%. Hepatic encephalopathy was a clinical problem. In 1960, Warren and collegues performed a distal splenorenal shunt, which reduced the incidenc...

A 67-year-old woman had hepatocellular carcinoma (HCC) measuring 3.7 cm at S8 of the liver with hyperammonemia due to a spontaneous giant mesocaval shunt. Admission laboratory data revealed albumin, 2.9 g/dL; total bilirubin, 1.3 mg/dL; plasma ammonia level (NH3), 152 g/dL; total bile acid (TBA) 108.5 μmoL/L; indocyanine green retention rate at 15 min (ICG15), 63%. Superior mesenteric arterial ...