An angiographic study of the pre- and postoperative hemodynamics in patients with side-to-side portacaval shunts.

Hepatic panangiography was performed in 17 patients before and after side-to-side portacaval shunts. Preoperatively, a direct correlation existed between the diameters of the hepatic arteries and the severity of the patient's cirrhosis. Postoperatively, the splenic artery and vein and the hepatic artery dilated further in most patients, reflecting increased blood flow. The greatest increase occured in those patients with less severe cirrhosis. The liver shrank postoperatively in most patients. The corrected sinusoidal pressure dropped significantly in all patients. A unique pattern of sinusoidal filling at wedged hepatic venography was observed postoperatively in many of the patients.