An ultrasonic duplex system facilitates detection of portal hemodynamic changes following selective shunts for esophageal varices

T. Iwanaga, M. Hashizume, N. Koyanagi, S. Kitano, K. Sugimachi, K. Inokuchi

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

We used an ultrasonic duplex system (US system) to assess portal hemodynamics in 52 patients with liver cirrhosis and esophageal varices, who underwent 2 types of distal splenorenal shunt (DSRS), conventional DSRS (group A, 8 patients) or DSRS with splenopancreatic disconnection (group B, 44 patients). The portal blood flow rate (PBF) was determined in 64 out of 70 patients (91.4%) and the shunt flow rate (SVF) in 39 out of 42 patients (92.9%) who had angiographically confirmed patent portal vein and shunt vein, during the peri- and postoperative period. In group A, a remarkably small amount of postoperative PBF (193 ml/min) and a concomitant increase in SVF (1039 ml/min) were evident. Such ultrasonic findings were compatible with a reduction in portal vein diameter, in accordance with the poor portal perfusion grade of the liver, and a transpancreatic stealing of the portal blood flow to the shunt, as evidenced by postoperative angiography. In contrast, the reduction in PBF was minimal, that is 663 ml/min preoperatively to 562 ml/min at discharge, and 536 ml/min at late follow-up, in group B patients. Significant alterations in portal circulation of the group B patients were not evident angiographically. This US systems is most useful to assess portal hemodynamics in patients with a selective shunt.

Original languageEnglish
Pages (from-to)73-77
Number of pages5
JournalHepato-gastroenterology
Volume35
Issue number2
Publication statusPublished - Jan 1 1988

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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