Oxygen supply to the cirrhotic liver following various portacaval shunt procedures.

Direct measurements of local oxygen pressure by means of a platinum multiwire electrode were performed to investigate the effect of five different portacaval shunt procedures on hepatic oxygen content in the cirrhotic rat liver. End-to-side shunt, side-to-side shunt, mesenterico caval shunt, splenocaval shunt, and portacaval transposition were performed and surface PO2 was determined immediately after operation, 24 hours following operation and after one week. Portacaval transposition and end-to-side shunt led to a striking oxygen deficit of the liver tissue with no incidence of compensation by the hepatic artery; Oxygen supply was improved considerably by a side-to-side shunt and tissue hypoxia could be prevented by a mesenterico-caval shunt and splenocaval shunt. This improving effect is thought to be due to the pancreatico-duodenal venous blood supply which should be carefully preserved for the liver circulation when a shunt needs to be performed.