Brief clinical report| Volume 87, ISSUE 5, P593-595, May 1980

Caudate lobe resection to reduce inferior vena caval hypertension prior to portacaval shunt

      This paper is only available as a PDF. To read, Please Download here.


      Coexistent caval and portal hypertension was recognized on preoperative angiographic study of a patient with cirrhosis and variceal bleeding. This hemodynamic situation can preclude adequate reduction of portal hypertension by portasystemic shunt and can result in fatal postoperative bleeding. Resection of a very large caudate lobe effectively reduced caval pressure and allowed a direct solution to the problem by portacaval anastomosis, rather than by more complex shunts or by nonshunting procedures previously suggested as alternatives.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Drapanas T
        Interposition mesocaval shunt for treatment of portal hypertension.
        Ann Surg. 1972; 176: 435-446
        • Maillard JN
        • Hay JM
        • Elman A
        • et al.
        Coexistent inferior vena caval and portal hypertension: splenic to left hepatic vein anastomosis in a cirrhotic patient.
        Arch Surg. 1974; 109: 819-821
        • Mullane JF
        • Gliedman ML
        Abdominal vena caval pressure and portal hypertension.
        Arch Surg. 1970; 101: 363-365
        • Reuter SR
        • Redman HC
        Gastrointestinal Angiography.
        in: ed 2. WB Saunders Co, Philadelphia1977: 321
        • Rikkers LF
        • Rudman D
        • Galambos JT
        • et al.
        A randomized controlled trial of the distal splenorenal shunt.
        Ann Surg. 1978; 188: 271-280
        • Salam AA
        • Warren WD
        • LePage JR
        Hemodynamic contrasts between selective and total portal-systemic decompression.
        Ann Surg. 1971; 173: 827-844
        • Thompson BW
        • Casali RE
        • Read RC
        • et al.
        Results of interposition “H” grafts for portal hypertension.
        Ann Surg. 1978; 187: 515-520
        • Warren WD
        • Salam AA
        • Hutson D
        • et al.
        Selective distal splenorenal shunt: Technique and results of operation.
        Arch Surg. 1974; 108: 306-314
        • Welling RE
        • McDermott WV
        Combined caval and portal hypertension with cirrhosis of the liver: a problem in management.
        Ann Surg. 1973; 177: 164-166