[Hepato-portal circulatory changes after splenorenal anastomosis]

Hepatoportal circulation changes after the shunt were examined angiographically in 5 patients subjected to splenoportal anastomosis and splenectomy. Arterioportography was employed in all cases. Catheterisation of the anastomosis was carried out in 1 patient and suprahepatic phlebography in another. The anastomosis was found to be patent in all cases. A hepatopetal portal flow was noted solely in the two patients examined six days after surgery. Disappearance of hepatic portal perfusion was observed in one of these patients on the 15th postoperative day. Controls carried out one month, one year, and five years after the operation showed that the mesenteric-portal flow was fully deviated through the shunt towards the vena cava in all patients. Selective hepatic arteriography showed an inverted portal flow in 3 patients. An increase in the calibre of the trunk of the hepatic artery and the entire intrahepatic artery network was always present.