Document Detail

Effect of portosystemic shunting on PGI2 and glucagon levels in humans.
MedLine Citation:
PMID:  8452403     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study determined if the proposed mediators of splanchnic blood flow, prostacyclin and glucagon, were elevated in patients with portal hypertension undergoing portal systemic shunts. SUMMARY BACKGROUND DATA: Chronic portal hypertension results in increased portal venous pressure and increased splanchnic blood flow. Animal studies have suggested prostacyclin or glucagon, potent vasodilators, as potential mediators of this increased flow. Correlative clinical studies have been difficult to perform due to the wide variation in degree of portal-systemic shunting and the frequent association of parenchymal liver disease in patients with cirrhosis. METHODS: The authors measured portal and systemic hemodynamics in PGI2 and glucagon levels in patients with portal hypertension due to cirrhosis (partial portal systemic shunt) and Budd-Chiari syndrome (complete portal systemic shunt) undergoing portal systemic shunts and in porto normotensive patients undergoing exploratory laparotomies. RESULTS: PGI2 levels in portal hypertension were significantly increased over normal, and prostacyclin in Budd-Chiari patients were increased significantly over patients with cirrhosis. Both PGI2 and portal venous pressure decreased significantly after portal systemic shunting, and prostacyclin levels correlated directly with portal venous pressure (R = 0.37, p < 0.05). CONCLUSIONS: This is the first evidence in humans supporting the hypothesis that PGI2 is elevated in portal hypertension and is related to both the degree of portal venous obstruction and portal pressure. PGI2 probably has a role in the abnormal splanchnic hemodynamics of human portal hypertension.
J V Sitzmann; K A Campbell; Y Wu; J L Cameron
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of surgery     Volume:  217     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-04-15     Completed Date:  1993-04-15     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  248-52     Citation Subset:  AIM; IM    
Johns Hopkins Medical Institutions, Baltimore, Maryland 21205.
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MeSH Terms
Blood Pressure
Budd-Chiari Syndrome / blood,  physiopathology,  surgery
Epoprostenol / blood*
Glucagon / blood*
Hypertension, Portal / blood,  physiopathology,  surgery
Intraoperative Period
Middle Aged
Portasystemic Shunt, Surgical*
Postoperative Period
Preoperative Care
Regression Analysis
Grant Support
Reg. No./Substance:
35121-78-9/Epoprostenol; 9007-92-5/Glucagon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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