IN MARCH, 1947, one of us (J. K. B.) began investigating the effects of hepatic and splenic artery ligations on portal pressures in normal and in portal hypertensive dogs. Summaries of this work have been presented,1 and a report of our first case2 has been published.
This paper is an account of our first 12 cases with advanced portal cirrhosis of the liver treated by hepatic, splenic, and left gastric arterial ligations.
INDICATIONS AND CONTRAINDICATIONS
These patients were operated upon because they were cirrhotics who did not respond to medical management, including use of cation-anion resins, and who, in addition, had symptoms and signs which are known to indicate a poor prognosis if allowed to persist or progress. The symptoms and signs in the order of their gravity were (1) rapid regression in the size of the liver; (2) bleeding varices or bleeding from the gastrointestinal tract; (3)