CLINICAL SIGNIFICANCE OF PERCUTANEOUS TRANSHEPATIC PORTAL CATHETERIZATION

A method of percutaneous transhepatic portal catheterization (PTPC) is now widely applied not only for clinical diagnosis and treatment, but also for clinical investigations of the hepatoportal system. As clinical applications of PTPC, portography, measurement of portal pressure and even embolization of the gastric coronary vein in portal hypertension have become available. As clinical investigations, on the other hand, it is possible to perform comparative studies between portal and peripheral blood, for the purpose of investigating metabolic mechanism of the liver in a certain pathophysiological state. And, this technique of PTPC is now performed almost as a routine or an essential examination in the liver, biliary and pancreatic diseases in our department, obtaining useful informations which is decisive of diagnosis and treatment. PTPC was done in 78 cases (56 cases of hepatic diseases and 22 cases of biliary stones), with successful performance in 75 cases. The successful rate was high up to 96%. As to complications, one case of possible intra-abdominal hemorrhage, 2 cases of transient fever and 2 cases of temporal exacerbation of liver function tests were encountered in the present study, which were satisfactorily controlled by medical treatments. From the experience, PTPC is considered fairly safe procedure. The external diameters of the catheters were from 1.35 to 1.58mm. At the same time, technical method of PTPC, portal pressures in various hepatic disorders and serum levels of IRI and CPR in both portal and peripheral systems were reported.