Observation of the hemodynamics in patients with portal hypertension: Before and after pericardial devascularization

Abstract

The hemodynamic changes of THBF (total hepatic blood flow), portography after PCDV (pericardial devascularization) and the cephalad portasystemic collaterals in the bleeders are reviewed. In 78 cases with bleeding varices, including 24 re-bleeders, the occurrence of coronary varices (88.46%) is much higher than that of short gastric varices (34.61%). There is a very significant difference between the two (P < 0.001). In analysing the relationship between the coronary varices in portography and bleeding of the esophageal varices pre and post-PCDV, we have recognized the role of the lesser splanchnic circulation of the portal system, especially the coronary vein, in the formation of the esophageal varices and bleeding. The value of THBF is 13.49 ± 0.84 (SE) m1/min/kg preoperatively and is increased to 15.96 ± 1.04(SE) m1/min/kg postoperatively. The postoperative value is increased by 18.31% (P < 0.01). Hemodynamically, PCDV is a rational procedure, which can not only control the variceal bleeding, but also increases hepatic blood perfusion.

Keywords

hemodynamics / total hepatic blood flow / lesser splanchnic circulation / cephalad portasystemic collaterals / portal venography

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