Two innovations in surgical therapy, one for cancer of the stomach and the other for portal hypertension, have involved ligation of the main arterial blood supply to the liver. In 1953, Appleby1 described 13 patients in whom he excised the celiac artery during en bloc resection for gastric carcinoma. In 1951, Rienhoff17 reported six patients with cirrhosis of the liver in whom the hepatic artery was ligated distal to the origin of the gastroduodenal. In 1952, Berman and Hull3 presented 12 cases of ligation of the hepatic, splenic, and left gastric arteries for advanced cirrhosis of the liver with bleeding esophageal varices.
Does ligation of the proximal hepatic artery or of the celiac artery in man damage the liver? At present there is little indication that it does. For example, all of Appleby's 13 patients survived celiac axis ligation without clinical signs of liver necrosis or alteration