Anatomic Study of the Portal Vein and Its Main Branches

THE ESTABLISHMENT of experimental portacaval shunts by Nikolai V. Eck¹in 1877 laid the foundation for the consideration of the surgical correction of portal hypertension. According to Rosenstein,²this was followed by the surgical thought and experimentation of Talma, Bier, Jersulem and Frank. Rosenstein²and de Martel and Vidal³completed portacaval anastomosis by the side to side technic early in the twentieth century. The work of Gad,⁴Herrick,⁵McIndoe,⁶Burton-Opitz,⁷Thomson,⁸Barger and Dale,⁹Whipple and his associates,¹⁰Bayliss and Starling¹¹and others laid the groundwork for the understanding of hepatic metabolism and blood flow in cirrhosis and in the presence of an Eck fistula. Mclndoe⁶demonstrated that the arterial bed of the liver seemed to be spared more than the portal in cirrhosis. With the improvement in vascular surgery and advance in physiology and diagnosis, there