Transhepatic venous catheterization and venography.

The portal venous system has generally been considered inaccessible except at laparotomy. During investigations in man on the relationship of the spleen and the liver in the dynamic physiology of the circulating formed elements of the blood, it became desirable to obtain blood repeatedly from the portal vein during relatively long periods of time. The procedure of direct transhepatic portal venipuncture was conceived in 1951 as a relatively simple clinical method of obtaining portal venous blood for this purpose. 1 The original description of the procedure on 14 patients was preliminary in nature and merely recorded the feasibility for short-term sampling. This report describes an improved technique for transhepatic venipuncture and catheterization of the portal and hepatic veins that has evolved from the experience gained during 144 transhepatic venipunctures performed on 73 patients during the past two years. MATERIALS AND METHODS Anatomic Considerations.— The portal vein in the normal adult