title: Caudate lobe resection to reduce inferior vena caval hypertension prior to portacaval shunt.
abstract: Coexistent caval and portal hypertension was recognized on preoperative angiographic study of a patient with cirrhosis and variceal bleeding. This hemodynamic situation can preclude adequate reduction of portal hypertension by portasystemic shunt and can result in fatal postoperative bleeding. Resection of a very large caudate lobe effectively reduced caval pressure and allowed a direct solution to the problem by portacaval anastomosis, rather than by more complex shunts or by nonshunting procedures previously suggested as alternatives.
mesh_terms: D004932:Esophageal and Gastric Varices / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000601:surgery*; D008099:Liver / Q000601:surgery*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical