Libertino J A, Zinman L, Breslin D J, Swinton N W
J Urol. 1976 Apr;115(4):369-72. doi: 10.1016/s0022-5347(17)59207-1.
Infrequently, when the aorta cannot be used for a standard renal bypass operation because of a previous aortic operation, severe degenerative atherosclerosis or complete aortic thrombosis, a unilateral (hepatic) or bilateral (hepatic and splenic) visceral bypass should be contemplated. Patients with abdominal aortic aneurysms extending above the renal arteries might benefit from concomitant bilateral visceral bypass procedures followed by aortic replacement during the same operative session. The hepatic circulation with its common anatomic variations, indications, surgical technique and effects of hepatorenal artery bypass on the renal and hepatic circulation are discussed.
偶尔，当由于既往主动脉手术、严重退行性动脉粥样硬化或完全性主动脉血栓形成而无法将主动脉用于标准的肾旁路手术时，应考虑进行单侧（肝）或双侧（肝和脾）内脏旁路手术。肾动脉上方延伸的腹主动脉瘤患者可能受益于同期双侧内脏旁路手术，随后在同一手术过程中进行主动脉置换。本文讨论了肝循环及其常见的解剖变异、适应证、手术技术以及肝肾动脉旁路对肾和肝循环的影响。
