Long‐term effects of distal splenorenal shunt on hepatic hemodynamics and liver function in patients with cirrhosis: Importance of reversal of portal blood flow
We studied 23 patients with cirrhosis who had undergone retroperitoneal distal splenorenal shunt without portal‐azygos disconnection more than 2 yr earlier. We investigated the suitability of the Doppler technique (ultrasound + Doppler) to assess the patency and blood flow direction through the port...
Gespeichert in:
| Veröffentlicht in: | Hepatology (Baltimore, Md.) Md.), 1992-04, Vol.15 (4), p.616-622 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 622 |
|---|---|
| container_issue | 4 |
| container_start_page | 616 |
| container_title | Hepatology (Baltimore, Md.) |
| container_volume | 15 |
| creator | Lacy, Antonio M. Navasa, Miguel Gilabert, Rosa Brü, Concepción García‐Pagán, Juan C. García‐Valdecasas, Juan C. Grande, Luis Feu, Fausto Fuster, José Terés, José Visa, José Bosch, Jaime |
| description | We studied 23 patients with cirrhosis who had undergone retroperitoneal distal splenorenal shunt without portal‐azygos disconnection more than 2 yr earlier. We investigated the suitability of the Doppler technique (ultrasound + Doppler) to assess the patency and blood flow direction through the portal vein and the distal splenorenal shunt and its correlation with the continuous thermal dilution technique. The study also assessed the influence of the distal splenorenal shunt and time after surgery on portal perfusion and liver function. Ultrasound + Doppler distal splenorenal shunt thrombosis in two patients; however, none was confirmed by continuous thermal dilution. Ultrasound + Doppler flowmetry was possible in 19 patients (83%) (mean, 1.58 ± 0.53 L/min). Distal splenorenal shunt continuous thermal dilution measurements were performed in all patients (100%), (mean, 1.65 ± 0.5 L/min). Good correlation was seen between them (r = 0.66). Ultrasound + Doppler of the portal vein showed a hepatopetal flow in 16 patients (69.9%). Hepatic blood flow was significantly higher in patients with hepatopetal flow (p = 0.003). Hepatic clearance and intrinsic hepatic clearance of indocyanine green were significantly lower in patients with hepatofugal flow. Patients with hepatofugal flow had a higher incidence of chronic encephalopathy. None of the patients with a follow‐up of less than 4 yr exhibited hepatofugal flow, whereas 7 of the 16 patients with a longer follow‐up had hepatofugal flow (43.7%). The difference was statistically significant (p = 0.04). This study suggests that ultrasound + Doppler sonography may provide useful data in the evaluation of the patency and blood flow direction through the portal vein and the distal splenorenal shunt. Direction of portal blood flow and time after surgery significantly affect hepatic portal perfusion and liver function. (Hepatology 1992;15:616–622). |
| doi_str_mv | 10.1002/hep.1840150411 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72855554</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>72855554</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3981-4098f70cd58c7dc151129094e8d38c9b87310ca3a470ba3c4ee2a720573aa40e3</originalsourceid><addsrcrecordid>eNqFkbFuFDEQhi0ECpdAS4fkAtHtZbxex146FCUk0kmhgHrl8445I6-92Ls5Xccj5Bl4NJ4EX-5E6HAzI883_2_PEPKGwZIB1OcbHJdMNcAENIw9IwsmallxLuA5WUAtoWoZb1-S05y_A0Db1OqEnDAh2AVvF-TXKoZvv38-TJgGitaimTKNlvYuT9rTPHoMMWHY55s5TDQGWiz15EyJQ-x3QQ_OZKpDT727x0TtHMzkCucC3YMYiuTWTRtqXEqbmF3-QG-HMaZJB4N7t4SlMRePkj_ee7r2MfbU-rh9RV5Y7TO-PsYz8vX66svlTbW6-3R7-XFVGd4qVjXQKivB9EIZ2RsmGKvb8l9UPVemXSvJGRjNdSNhrblpEGstaxCSa90A8jPy_qA7pvhjxjx1g8sGvdcB45w7WStRTlPA5QE0Keac0HZjcoNOu45Bt19KVybUPS2lNLw9Ks_rAfsn_LCFUn93rOtstLepzMXlv5i4ANlIWbD2gG2dx91_TLubq8__POEPK66pZg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72855554</pqid></control><display><type>article</type><title>Long‐term effects of distal splenorenal shunt on hepatic hemodynamics and liver function in patients with cirrhosis: Importance of reversal of portal blood flow</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Lacy, Antonio M. ; Navasa, Miguel ; Gilabert, Rosa ; Brü, Concepción ; García‐Pagán, Juan C. ; García‐Valdecasas, Juan C. ; Grande, Luis ; Feu, Fausto ; Fuster, José ; Terés, José ; Visa, José ; Bosch, Jaime</creator><creatorcontrib>Lacy, Antonio M. ; Navasa, Miguel ; Gilabert, Rosa ; Brü, Concepción ; García‐Pagán, Juan C. ; García‐Valdecasas, Juan C. ; Grande, Luis ; Feu, Fausto ; Fuster, José ; Terés, José ; Visa, José ; Bosch, Jaime</creatorcontrib><description>We studied 23 patients with cirrhosis who had undergone retroperitoneal distal splenorenal shunt without portal‐azygos disconnection more than 2 yr earlier. We investigated the suitability of the Doppler technique (ultrasound + Doppler) to assess the patency and blood flow direction through the portal vein and the distal splenorenal shunt and its correlation with the continuous thermal dilution technique. The study also assessed the influence of the distal splenorenal shunt and time after surgery on portal perfusion and liver function. Ultrasound + Doppler distal splenorenal shunt thrombosis in two patients; however, none was confirmed by continuous thermal dilution. Ultrasound + Doppler flowmetry was possible in 19 patients (83%) (mean, 1.58 ± 0.53 L/min). Distal splenorenal shunt continuous thermal dilution measurements were performed in all patients (100%), (mean, 1.65 ± 0.5 L/min). Good correlation was seen between them (r = 0.66). Ultrasound + Doppler of the portal vein showed a hepatopetal flow in 16 patients (69.9%). Hepatic blood flow was significantly higher in patients with hepatopetal flow (p = 0.003). Hepatic clearance and intrinsic hepatic clearance of indocyanine green were significantly lower in patients with hepatofugal flow. Patients with hepatofugal flow had a higher incidence of chronic encephalopathy. None of the patients with a follow‐up of less than 4 yr exhibited hepatofugal flow, whereas 7 of the 16 patients with a longer follow‐up had hepatofugal flow (43.7%). The difference was statistically significant (p = 0.04). This study suggests that ultrasound + Doppler sonography may provide useful data in the evaluation of the patency and blood flow direction through the portal vein and the distal splenorenal shunt. Direction of portal blood flow and time after surgery significantly affect hepatic portal perfusion and liver function. (Hepatology 1992;15:616–622).</description><identifier>ISSN: 0270-9139</identifier><identifier>EISSN: 1527-3350</identifier><identifier>DOI: 10.1002/hep.1840150411</identifier><identifier>PMID: 1551639</identifier><identifier>CODEN: HPTLD9</identifier><language>eng</language><publisher>Philadelphia, PA: W.B. Saunders</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Female ; Hemodynamics ; Humans ; Liver - diagnostic imaging ; Liver - physiopathology ; Liver Circulation ; Liver Cirrhosis - physiopathology ; Liver Cirrhosis - surgery ; Male ; Medical sciences ; Middle Aged ; Portal System - physiopathology ; Splenorenal Shunt, Surgical ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Time Factors ; Ultrasonography</subject><ispartof>Hepatology (Baltimore, Md.), 1992-04, Vol.15 (4), p.616-622</ispartof><rights>Copyright © 1992 Wiley Subscription Services, Inc.</rights><rights>1992 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3981-4098f70cd58c7dc151129094e8d38c9b87310ca3a470ba3c4ee2a720573aa40e3</citedby><cites>FETCH-LOGICAL-c3981-4098f70cd58c7dc151129094e8d38c9b87310ca3a470ba3c4ee2a720573aa40e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhep.1840150411$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhep.1840150411$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5607477$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1551639$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lacy, Antonio M.</creatorcontrib><creatorcontrib>Navasa, Miguel</creatorcontrib><creatorcontrib>Gilabert, Rosa</creatorcontrib><creatorcontrib>Brü, Concepción</creatorcontrib><creatorcontrib>García‐Pagán, Juan C.</creatorcontrib><creatorcontrib>García‐Valdecasas, Juan C.</creatorcontrib><creatorcontrib>Grande, Luis</creatorcontrib><creatorcontrib>Feu, Fausto</creatorcontrib><creatorcontrib>Fuster, José</creatorcontrib><creatorcontrib>Terés, José</creatorcontrib><creatorcontrib>Visa, José</creatorcontrib><creatorcontrib>Bosch, Jaime</creatorcontrib><title>Long‐term effects of distal splenorenal shunt on hepatic hemodynamics and liver function in patients with cirrhosis: Importance of reversal of portal blood flow</title><title>Hepatology (Baltimore, Md.)</title><addtitle>Hepatology</addtitle><description>We studied 23 patients with cirrhosis who had undergone retroperitoneal distal splenorenal shunt without portal‐azygos disconnection more than 2 yr earlier. We investigated the suitability of the Doppler technique (ultrasound + Doppler) to assess the patency and blood flow direction through the portal vein and the distal splenorenal shunt and its correlation with the continuous thermal dilution technique. The study also assessed the influence of the distal splenorenal shunt and time after surgery on portal perfusion and liver function. Ultrasound + Doppler distal splenorenal shunt thrombosis in two patients; however, none was confirmed by continuous thermal dilution. Ultrasound + Doppler flowmetry was possible in 19 patients (83%) (mean, 1.58 ± 0.53 L/min). Distal splenorenal shunt continuous thermal dilution measurements were performed in all patients (100%), (mean, 1.65 ± 0.5 L/min). Good correlation was seen between them (r = 0.66). Ultrasound + Doppler of the portal vein showed a hepatopetal flow in 16 patients (69.9%). Hepatic blood flow was significantly higher in patients with hepatopetal flow (p = 0.003). Hepatic clearance and intrinsic hepatic clearance of indocyanine green were significantly lower in patients with hepatofugal flow. Patients with hepatofugal flow had a higher incidence of chronic encephalopathy. None of the patients with a follow‐up of less than 4 yr exhibited hepatofugal flow, whereas 7 of the 16 patients with a longer follow‐up had hepatofugal flow (43.7%). The difference was statistically significant (p = 0.04). This study suggests that ultrasound + Doppler sonography may provide useful data in the evaluation of the patency and blood flow direction through the portal vein and the distal splenorenal shunt. Direction of portal blood flow and time after surgery significantly affect hepatic portal perfusion and liver function. (Hepatology 1992;15:616–622).</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Liver - diagnostic imaging</subject><subject>Liver - physiopathology</subject><subject>Liver Circulation</subject><subject>Liver Cirrhosis - physiopathology</subject><subject>Liver Cirrhosis - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Portal System - physiopathology</subject><subject>Splenorenal Shunt, Surgical</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Time Factors</subject><subject>Ultrasonography</subject><issn>0270-9139</issn><issn>1527-3350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkbFuFDEQhi0ECpdAS4fkAtHtZbxex146FCUk0kmhgHrl8445I6-92Ls5Xccj5Bl4NJ4EX-5E6HAzI883_2_PEPKGwZIB1OcbHJdMNcAENIw9IwsmallxLuA5WUAtoWoZb1-S05y_A0Db1OqEnDAh2AVvF-TXKoZvv38-TJgGitaimTKNlvYuT9rTPHoMMWHY55s5TDQGWiz15EyJQ-x3QQ_OZKpDT727x0TtHMzkCucC3YMYiuTWTRtqXEqbmF3-QG-HMaZJB4N7t4SlMRePkj_ee7r2MfbU-rh9RV5Y7TO-PsYz8vX66svlTbW6-3R7-XFVGd4qVjXQKivB9EIZ2RsmGKvb8l9UPVemXSvJGRjNdSNhrblpEGstaxCSa90A8jPy_qA7pvhjxjx1g8sGvdcB45w7WStRTlPA5QE0Keac0HZjcoNOu45Bt19KVybUPS2lNLw9Ks_rAfsn_LCFUn93rOtstLepzMXlv5i4ANlIWbD2gG2dx91_TLubq8__POEPK66pZg</recordid><startdate>199204</startdate><enddate>199204</enddate><creator>Lacy, Antonio M.</creator><creator>Navasa, Miguel</creator><creator>Gilabert, Rosa</creator><creator>Brü, Concepción</creator><creator>García‐Pagán, Juan C.</creator><creator>García‐Valdecasas, Juan C.</creator><creator>Grande, Luis</creator><creator>Feu, Fausto</creator><creator>Fuster, José</creator><creator>Terés, José</creator><creator>Visa, José</creator><creator>Bosch, Jaime</creator><general>W.B. Saunders</general><general>Wiley</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199204</creationdate><title>Long‐term effects of distal splenorenal shunt on hepatic hemodynamics and liver function in patients with cirrhosis: Importance of reversal of portal blood flow</title><author>Lacy, Antonio M. ; Navasa, Miguel ; Gilabert, Rosa ; Brü, Concepción ; García‐Pagán, Juan C. ; García‐Valdecasas, Juan C. ; Grande, Luis ; Feu, Fausto ; Fuster, José ; Terés, José ; Visa, José ; Bosch, Jaime</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3981-4098f70cd58c7dc151129094e8d38c9b87310ca3a470ba3c4ee2a720573aa40e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Liver - diagnostic imaging</topic><topic>Liver - physiopathology</topic><topic>Liver Circulation</topic><topic>Liver Cirrhosis - physiopathology</topic><topic>Liver Cirrhosis - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Portal System - physiopathology</topic><topic>Splenorenal Shunt, Surgical</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Time Factors</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lacy, Antonio M.</creatorcontrib><creatorcontrib>Navasa, Miguel</creatorcontrib><creatorcontrib>Gilabert, Rosa</creatorcontrib><creatorcontrib>Brü, Concepción</creatorcontrib><creatorcontrib>García‐Pagán, Juan C.</creatorcontrib><creatorcontrib>García‐Valdecasas, Juan C.</creatorcontrib><creatorcontrib>Grande, Luis</creatorcontrib><creatorcontrib>Feu, Fausto</creatorcontrib><creatorcontrib>Fuster, José</creatorcontrib><creatorcontrib>Terés, José</creatorcontrib><creatorcontrib>Visa, José</creatorcontrib><creatorcontrib>Bosch, Jaime</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology (Baltimore, Md.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lacy, Antonio M.</au><au>Navasa, Miguel</au><au>Gilabert, Rosa</au><au>Brü, Concepción</au><au>García‐Pagán, Juan C.</au><au>García‐Valdecasas, Juan C.</au><au>Grande, Luis</au><au>Feu, Fausto</au><au>Fuster, José</au><au>Terés, José</au><au>Visa, José</au><au>Bosch, Jaime</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long‐term effects of distal splenorenal shunt on hepatic hemodynamics and liver function in patients with cirrhosis: Importance of reversal of portal blood flow</atitle><jtitle>Hepatology (Baltimore, Md.)</jtitle><addtitle>Hepatology</addtitle><date>1992-04</date><risdate>1992</risdate><volume>15</volume><issue>4</issue><spage>616</spage><epage>622</epage><pages>616-622</pages><issn>0270-9139</issn><eissn>1527-3350</eissn><coden>HPTLD9</coden><abstract>We studied 23 patients with cirrhosis who had undergone retroperitoneal distal splenorenal shunt without portal‐azygos disconnection more than 2 yr earlier. We investigated the suitability of the Doppler technique (ultrasound + Doppler) to assess the patency and blood flow direction through the portal vein and the distal splenorenal shunt and its correlation with the continuous thermal dilution technique. The study also assessed the influence of the distal splenorenal shunt and time after surgery on portal perfusion and liver function. Ultrasound + Doppler distal splenorenal shunt thrombosis in two patients; however, none was confirmed by continuous thermal dilution. Ultrasound + Doppler flowmetry was possible in 19 patients (83%) (mean, 1.58 ± 0.53 L/min). Distal splenorenal shunt continuous thermal dilution measurements were performed in all patients (100%), (mean, 1.65 ± 0.5 L/min). Good correlation was seen between them (r = 0.66). Ultrasound + Doppler of the portal vein showed a hepatopetal flow in 16 patients (69.9%). Hepatic blood flow was significantly higher in patients with hepatopetal flow (p = 0.003). Hepatic clearance and intrinsic hepatic clearance of indocyanine green were significantly lower in patients with hepatofugal flow. Patients with hepatofugal flow had a higher incidence of chronic encephalopathy. None of the patients with a follow‐up of less than 4 yr exhibited hepatofugal flow, whereas 7 of the 16 patients with a longer follow‐up had hepatofugal flow (43.7%). The difference was statistically significant (p = 0.04). This study suggests that ultrasound + Doppler sonography may provide useful data in the evaluation of the patency and blood flow direction through the portal vein and the distal splenorenal shunt. Direction of portal blood flow and time after surgery significantly affect hepatic portal perfusion and liver function. (Hepatology 1992;15:616–622).</abstract><cop>Philadelphia, PA</cop><pub>W.B. Saunders</pub><pmid>1551639</pmid><doi>10.1002/hep.1840150411</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0270-9139 |
| ispartof | Hepatology (Baltimore, Md.), 1992-04, Vol.15 (4), p.616-622 |
| issn | 0270-9139 1527-3350 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72855554 |
| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Adult Aged Biological and medical sciences Female Hemodynamics Humans Liver - diagnostic imaging Liver - physiopathology Liver Circulation Liver Cirrhosis - physiopathology Liver Cirrhosis - surgery Male Medical sciences Middle Aged Portal System - physiopathology Splenorenal Shunt, Surgical Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Time Factors Ultrasonography |
| title | Long‐term effects of distal splenorenal shunt on hepatic hemodynamics and liver function in patients with cirrhosis: Importance of reversal of portal blood flow |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-11T16%3A33%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Long%E2%80%90term%20effects%20of%20distal%20splenorenal%20shunt%20on%20hepatic%20hemodynamics%20and%20liver%20function%20in%20patients%20with%20cirrhosis:%20Importance%20of%20reversal%20of%20portal%20blood%20flow&rft.jtitle=Hepatology%20(Baltimore,%20Md.)&rft.au=Lacy,%20Antonio%20M.&rft.date=1992-04&rft.volume=15&rft.issue=4&rft.spage=616&rft.epage=622&rft.pages=616-622&rft.issn=0270-9139&rft.eissn=1527-3350&rft.coden=HPTLD9&rft_id=info:doi/10.1002/hep.1840150411&rft_dat=%3Cproquest_cross%3E72855554%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=72855554&rft_id=info:pmid/1551639&rfr_iscdi=true |