Portacaval shunt in the pig 2. Evaluation of functional changes of the liver by a compartmental bromsulphthalein (BSP) test.

ASSESSMENT OF LIVER FUXCTION IN PATIENTS with hepatic disease by means of routine liver function tests is unreliable. Furthermore, these tests do not provide quantitative information that would allow assessment of the progress of the liver disorder after operations such as portacaval shunt (PCS) performed for bleeding oesophageal varices. In recent years attempts have been made to provide this information by studying the kinetics of the plasma clearance of dyes such as indocyanine green and bromsulphthalein (BSP) [4, 17, 221 and by studying the removal rates of constant infusions of BSP [4, 251. These methods can provide data relating to hepatic uptake, storage, metabolism, and biliary excretion, and hence enable an overall assessment of the functional status of the liver in quantitative terms. Although PCS is a successful procedure for variceal hemorrhage it results in deterioration of hepatic function [6, 11, 161. However, as the disease process, such as cirrhosis, may progress with time whether a portacaval shunt is performed or not, the effects of this operation on hepatic function are difficult to evaluate. An attempt has been made to assess the changes in liver function after PCS in pigs without liver disease by studying the kinetics of BSP clearance using a compartmental model and a preliminary report has been presented [2]. In some of the pigs values for the bil-