Portacaval Diversion for Severe Hypercholesterolemia

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Abstract
• An end-to-side portacaval shunt was performed in a patient with severe coronary arteriosclerosis and type Ila hypercholesterolemia. By one year postoperatively there was a decrease of serum cholesterol concentration of more than 40%. No adverse side effects were noted. Intravenous and oral glucose tolerance tests were performed and were within normal range preoperatively and postoperatively. However, preoperatively, during the oral test, the serum insulin levels exceeded the normal range. In addition, glucagon levels revealed less tendency to suppression during the preoperative oral tests. Psychological testing revealed no abnormalities, and serum ammonia levels were only slightly elevated. (Arch Surg 112:634-636, 1977)