The Effect of Artificial Portocaval Anastomosis or Splenectomy on Hepatic and Portal Haemodynamics in Cirrhotics

1969 ◽  
Vol 08 (03) ◽  
pp. 232-241
Author(s):  
J. Vosmík ◽  
V. Bláha
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Liver Blood Flow ◽  
Severe Liver ◽  
Portocaval Anastomosis ◽  
Average Decrease ◽  
Modified Method ◽  
Portosystemic Shunts ◽  
Before And After

SummaryUsing their own modified method the authors simultaneously examined the blood clearances of 198Au colloid and 131I-Rose Bengal and determined the ratio1. in a group of 11 patients with severe liver cirrhosis, portal hypertension and portosystemic shunts, both before and after artificial portocaval anastomosis, and2. in two patients with thrombosis v. lienalis, excessive splenomegaly and extensive portosystemic shunts before and after splenectomy. Ad 1. In 6 patients 55%) a reduction of the effective liver blood flow occured due to the artificial portosystemic anastomosis; the average decrease was ~ 20%. In 7 patients a significant enlargement of the total splenosystemic flow was observed as a result of the artificial communication.Ad 2. In both patients an increase of the effective liver blood flow occured after splenectomy. The minimal preoperative splenosystemic flow was ~ 0.152 and ~ 0.089 of the circulating blood per minute (expressed by means of kAu).The authors discuss the significance of the kAu and kBR values as well as that of the ratio for the estimation of changes in hepatic and portal haemodynamics.

scholarly journals Systemic and Splanchnic Lipopolysaccharide and Endothelin-1 Plasma Levels in Liver Cirrhosis before and after Transjugular Intrahepatic Portosystemic Shunt

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Jiaxiang Meng ◽  
Qing Wang ◽  
Kai Liu ◽  
Shuofei Yang ◽  
Xinxin Fan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Bacterial Translocation ◽  
Portosystemic Shunt ◽  
Before And After ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhotic Patients

Lipopolysaccharide (LPS) and endothelin- (ET-) 1 may aggravate portal hypertension by increasing intrahepatic resistance and splanchnic blood flow. In the portal vein, after TIPS shunting, LPS and ET-1 were significantly decreased. Our study suggests that TIPS can benefit cirrhotic patients not only in high hemodynamics related variceal bleeding but also in intestinal bacterial translocation associated complications such as endotoxemia.

scholarly journals Noninvasive diagnosis of portal hypertension and esophageal varices through the identification of liver blood flow markers

Hepatology ◽  
2014 ◽  
Vol 60 (2) ◽  
pp. 762-762 ◽  
Author(s):  
Andrea Lisotti ◽  
Francesco Azzaroli ◽  
Marco Montagnani ◽  
Giuseppe Mazzella
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Liver Blood Flow ◽  
Noninvasive Diagnosis

Combined endoscopic intervention (ligation+sclerotherapy) compared with TIPS for prevention of bleeding from gastro-esophageal varices in patients with liver cirrhosis

2016 ◽  
Vol 5 (1) ◽  
pp. 124
Author(s):  
Utkirbek Matkuliev
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Varicose Veins ◽  
Portal System ◽  
Endoscopic Intervention ◽  
Portosystemic Shunts ◽  
System Pressure ◽  
Intrahepatic Portosystemic Shunt ◽  
History Of ◽  
The Mean

Background: Liver cirrhosis (LC) and portal hypertension (PH) is one of the most serious problems of modern surgical hepatology. The most common complication of liver cirrhosis is bleeding from varicose veins of esophagus and stomach. Today experts have several ways to prevent rebleeding from varices: pharmacotherapy, endoscopic intervention, transjugular intrahepatic portosystemic shunt (TIPS), a surgical portocaval bypass. Purpose of this study was to compare effectiveness of transjugular intrahepatic portosystemic shunts (TIPS) and combined endoscopic therapy the management of bleeding in cirrhotic patients.Methods: We observed 96 consecutive patients with portal hypertension who were treated in 2nd clinic of Tashkent Medical Academy (2014-2015). Bleeding was in history of 17 (17.7%) patients. The duration of the bleeding averaged 9.7±4.3 hours. Ascites was observed in 54.5 % of patients. Patients were divided two major groups. First group included 72 patients who was performed endoscopic intervention. Second group consisted of 24 patients who underwent TIPS in emergency cases.Results: Seventy-two patients were assigned to variceal ligation and Sclerotherapy, other 24 patients to TIPS. In the ligation combined Sclerotherapy group, a second treatment was performed 8–10 days after the initial endoscopy. Deterioration of portal gastropathy was observed in 9 (9.4%) cases after EL and 24 (25.0%) after ES (p <0.05). The mean portal system pressure prior to TIPS placement was 53.67±4.21 mm Hg, which decreased to 25.10±4.06 mmHg after the first shunt tract was established (P <0.001). The mean portal system pressure prior to the second TIPS was 43.68±3.98 mm Hg and decreased to 25.14±4.67 mm Hg after the procedures (P <0.001).Conclusions: TIPS can become dysfunctional if stenosis develops in the shunt or the hepatic vein above the shunt. Screening allows detection of stenosis before portal hypertensive–related complications recur. Revision of stenotic shunts can be easily accomplished in most cases. Techniques for screening and revision will be discussed. This is one of the most effective methods to control patients with liver cirrhosis.

Renal blood flow before and after portosystemic shunt in children with portal hypertension

2014 ◽  
Vol 30 (3) ◽  
pp. 295-299 ◽  
Author(s):  
Makhmud M. Aliev ◽  
Rustam Z. Yuldashev ◽  
Gulnara S. Adilova ◽  
Gulnora A. Yusupaileva
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Renal Blood Flow ◽  
Portosystemic Shunt ◽  
Before And After

Liver perfusion scintigraphy prior to and after transjugular intrahepatic portosystemic shunts (TIPS) in patients with portal hypertension

2000 ◽  
Vol 39 (05) ◽  
pp. 139-141 ◽  
Author(s):  
A. Schoniburg ◽  
K. A. Brensing ◽  
K. Reichmann ◽  
M. Bangard ◽  
B. Overbeck ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Perfusion ◽  
Venous Pressure ◽  
Portal Pressure ◽  
Interventional Treatment ◽  
Perfusion Scintigraphy ◽  
Portosystemic Shunts ◽  
Shunt Procedure ◽  
Before And After ◽  
Intrahepatic Portosystemic Shunt

Summary Purpose: This investigation was performed to compare the hemodynamic results of the transjugular intrahepatic portosystemic shunt, a new interventional treatment for portal hypertension, with those observed after the established surgical shunt interventions. Methods: We examined 22 patients with portal hypertension due to liver cirrhosis before and after elective TIPS by liver perfusion scintigraphy. The relative portal perfusion was determined before and after the shunt procedure. Additionally, we measured the portal pressure gradient (PPG: portal-central venous pressure, mmHg). Results: Prior to TIPS, the relative portal perfusion was significantly reduced to 22 ± 9.1%. After the intervention we calculated values of 23.1 ± 10,7% in the TIPS-group (p = 0.67; not significant). In spite of unchanged portal perfusion, the portal pressure was significantly (p <0.001) reduced from 25.6 ± 5.3 to 14.8 ± 4 mm Hg. Conclusion: These results suggest that the reduction of portal hypertension by TIPS is effective. The portal perfusion is maintained by TIPS suggesting that liver perfusion is preserved to a higher degree.

Survival and quality of life after portal blood flow preserving procedures in patients with portal hypertension and liver cirrhosis

1994 ◽  
Vol 168 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Hector Orozco ◽  
Miguel Angel Mercado ◽  
Takeshi Takahashi ◽  
Gilberto Rojas ◽  
Jorge Hernández ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Blood Flow ◽  
Portal Blood
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