HEMeng-guo , SHENNai-ying , TANDong , ZHENGKang , ZHANGTian-zheng , LIANGGang , WANGZhi-xiang.
  • Department of Hepatobiliary, No. 215 Hospital of Shaanxi Nuclear Industry, Xianyang 712000, Shaanxi Province, China;
HEMeng-guo, Email: hemengguo04@126.com
Portal hypertension; Cirrhosis; Splenectomy; Pericardial devascularization; Hemodynamics; Liver function
10.7507/1007-9424.20160255
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Objective To investigate impact of splenectomy plus pericardial devascularization on liver hemodynamics and liver function for liver cirrhosis patients with portal hypertension. Methods The internal diameter, maximum velocity, minimum velocity, mean velocity, and flow volume of portal vein and hepatic artery of 42 cases of liver cirrhosis with portal hypertension were measured by Doppler ultrasonic instrument on day 1 before operation and on day 7 after operation. The free portal pressures at different phases (after open abdomen, after splenic artery ligation, after splenectomy, and after devasculanrization) were read from the disposable pressure sensor. Twenty-four healthy people through physical examination were selected as control. Results ① The free portal pressure of liver cirrhosis patients with portal hypertension was decreased from (29.12±1.40) mm Hg after open abdomen to (22.71±1.21) mm Hg after splenic artery ligation, and further decreased to (21.32±1.12) mm Hg after splenectomy, but increased to (22.42±1.15) mm Hg after devasculanrization, the difference was statisticly different (all P < 0.01). ② Compared with the healthy people, for the liver cirrhosis patients with portal hypertension, the internal diameter, maximum velocity, minimum velocity, and flow volume of portal vein were significantly enlarged (all P < 0.01), which of hepatic artery were significantly reduced (all P < 0.01) on day 1 before operation; On day 7 after operation, the internal diameter of portal vein was significantly reduced (P < 0.01), the maximum velocity, minimum velocity, and mean velocity of portal vein were significantly enlarged (all P < 0.01), but the internal diameter of hepatic artery was significantly reduced (P < 0.01), the maximum velocity, minimum velocity, mean velocity, and flow volume of hepatic artery were significantly enlarged (all P < 0.01). For the liver cirrhosis patients with portal hypertension, compared with the values on day 1 before operation, the internal diameter and the flow volume of portal vein were significantly reduced (all P < 0.01) on day 7 after operation; the internal diameter, maximum velocity, minimum velocity, mean velocity, and flow volume of hepatic artery were significantly enlarged (all P < 0.01) on day 7 after operation. ③ The Child-Pugh classification of liver function between before and after surgery had no significant difference (χ2=1.050, P > 0.05). ④ No death and no hepatic encephalopathy occurred, no thrombosis of splenic vein or portal vein was observed on day 7 after surgery. Conclusion splenectomy plus pericardial devascularization could decrease portal vein pressure and reduce blood flow of portal vein, while increase blood flow of hepatic artery, it doesn't affect liver function.

Citation： HEMeng-guo, SHENNai-ying, TANDong, ZHENGKang, ZHANGTian-zheng, LIANGGang, WANGZhi-xiang.. Impact of Splenectomy Plus Pericardial Devascularization on Liver Hemodynamics and Liver Function for Liver Cirrhosis Patients with Portal Hypertension. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(8): 978-981. doi: 10.7507/1007-9424.20160255 Copy

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