DETERMINATION OF PORTAL BLOOD OPTIMAL SHUNTING VOLUME PRIOR TO THE SURGERY IN EXTRAHEPATIC PORTAL HYPERTENSION

Abstract

Purpose of the study: to determine the necessary shunt diameter and optimal shunting volume of portal blood in children with extrahepatic portal hypertension prior to portosystemic shunting. Methods of the study: a complex ultrasound examination was carried out (B mode in real time and duplex scanning in color flow mapping mode). Changes in the liver hemodynamics before and after portosystemic shunting were examined. In 30 children the surgery was done without determination of the necessary shunt diameter. Determination of diameter, speed characteristics and blood flow in the vessels of the portal system, hepatic and splenic arteries was done in 51 patients prior to the surgery to determine the necessary shunting volume. Material performance: 106 children aged 4 to 7 were examined. 25 of them were healthy and 81 children had extrahepatic portal hypertension. Results: it was established that before portosystemic shunting in patients with extrahepatic portal hypertension it is necessary to determine the diameter of the shunt and volume of blood shunting needed to preserve the portal blood flow in the liver and decrease the pressure in the portal system effectively. Conclusion: portosystemic shunting decreases the portal pressure, preserves hepatic hemodynamics and prevents esophagogastric hemorrhages in patients with extrahepatic portal hypertension with individual determination of the necessary volume of blood shunting.

References

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RIGHTS & PERMISSIONS

Ranchaeva N.A., Yurchuk V.A.