Role of Portal Venous Blood Supply from the Pancreas in Maintaining Hepatic Functional Reserve. Appraisal of Warren's Shunt Operation

Mitochondrial phosphorylative activity was measured in the livers of various shunted or pancreatectomized dogs. In simple portal vein branch-ligated dogs, the mitochondrial phosphorylative activity in the nonligated lobe, which was supplied with excess portal blood, increased to approximately 150% of control values. In splenocaval-shunted or totally pancreatectomized dogs, the mitochondrial phosphorylative activity did not increase even in the nonligated lobe. However, the mitochondrial phosphorylative activity in the nonligated lobe increased to 120% of control in 80%-pancreatectomized and 150% in 50%-pancreatectomized dogs. In distal splenorenal-shunted (Warren-shunted) dogs, the mitochondrial phosphorylative activity increased to 150% of control values. Thus, the Warren's shunt operation is considered to be the more reasonable procedure for treatment of liver cirrhosis with esophageal varices, from the point of view of hepatic functional reserve based on the energetic metabolism of the liver.