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Long-term hemodynamic effects of portocaval shunt and Sugiura procedure in patients with cirrhosis.
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MedLine Citation:
PMID:  8809580     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Systemic and splanchnic hemodynamics were studied before and six months after a portal systemic shunt (n = 6) or a Sugiura procedure (n = 9) in 15 patients with cirrhosis and a past history of variceal bleeding. Hepatic blood flow was estimated by hepatic extraction and clearance of continuous indocyanine green infusion. Azygos blood flow was measured with a continuous thermodilution catheter. After portocaval shunt, the cardiac index increased significantly from 4.0 +/- .4 to 5.4 +/- 0.8 l/min m2 (p < 0.05), the hepatic venous pressure gradient and hepatic blood flow were significantly decreased from 21 +/- 3 to 13 +/- 5 mm Hg (p < 0.05) and from 1.20 +/- 0.35 to 0.37 +/- 0.16 l/min (p < 0.05) respectively. The decrease in azygos blood flow was not significant (0.51 +/- 0.31 vs 0.25 +/- 0.33 l/min; p = 0.1). After Sugiura procedure, there was no significant change in cardiac index, hepatic venous pressure gradient, hepatic blood flow or azygos blood flow. This is the first study to show the long-term maintenance of splanchnic and systemic hemodynamics in patients with cirrhosis after Sugiura procedure. The absence of long-term hemodynamic alterations could explain the absence of encephalopathy after this procedure.
Authors:
C Vons; A Hadengue; C Smadja; D Franco; D Lebrec
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  HPB surgery : a world journal of hepatic, pancreatic and biliary surgery     Volume:  9     ISSN:  0894-8569     ISO Abbreviation:  HPB Surg     Publication Date:  1996  
Date Detail:
Created Date:  1996-12-05     Completed Date:  1996-12-05     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  9002972     Medline TA:  HPB Surg     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  209-13     Citation Subset:  IM    
Affiliation:
Groupe de Recherche sur la Chirurgia du Foie et de l'Hypertension Portale, Hôpital Antoine Béclère, France.
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MeSH Terms
Descriptor/Qualifier:
Azygos Vein / physiopathology
Blood Flow Velocity
Blood Pressure
Cardiac Output
Esophageal and Gastric Varices / etiology,  physiopathology,  surgery*
Female
Heart Rate
Hemodynamics*
Humans
Liver Circulation
Liver Cirrhosis, Alcoholic / complications,  physiopathology*,  surgery
Male
Middle Aged
Portacaval Shunt, Surgical*
Prospective Studies
Splanchnic Circulation
Vascular Resistance

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

Full Text
Journal Information
Journal ID (nlm-ta): HPB Surg
ISSN: 0894-8569
ISSN: 1607-8462
Publisher: Hindawi Publishing Corporation
Article Information
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Copyright ? 1996 Hindawi Publishing Corporation.
open-access: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received Day: 29 Month: 6 Year: 1994
Print publication date: Year: 1996
Volume: 9 Issue: 4
First Page: 209 Last Page: 213
ID: 2443776
PubMed Id: 8809580
Publisher Item Identifier: S0894856996464761
DOI: 10.1155/1996/46476

Long-Term Hemodynamic Effects of Portocaval Shunt and Sugiura Procedure in Patients with Cirrhosis
Corinne Vons2
Antoine Hadengue1
Claude Smadja1
Dominique Franco1
Didier Lebrec1
1From the Groupe de Recherche sur la Chirurgie du Foie et de l'Hypertension PortaleH?pital Antoine B?cl?reClamart and from Unit? de Recherches de Physiopathologie H?patiqueINSERM U 24, H?pital BeaujonClichyFrance
2Service de ChirurgieH?pital Antoine B?cl?re157 rue de la Porte de TrivauxClamart cedex92141France


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