肝硬変の肝外門脈血行異常について-門脈造影法を中心に-

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We studied the abnormality of extrahepatic portal hemodynamics in 37 cases with liver cirrhosis, by percutaneous transhepatic portography and divided the subjects into two groups, i.e. 20 cases having mainly the collaterals except esophageal varices [group I]and 17 cases of the esophageal varices [group II].<BR>In group I, there were 8 paraumbilical, 4 gastro-renal, 2 spleno-renal and 6 superior or inferior mesenteric vein-inferior vena cava shuntings. Twelve cases (60%) had hepatic encephalopathy in group I (5 paraumbilical, 1 spleno-renal and all 6 superior or inferior mesenteric vein-inferior vena cava shuntings). On the other hand, only one case (6%) had hepatic encephalopathy in group II, whose esophageal varices were diverted from the superior mesenteric vein. The occurrence of hepatic encephalopathy had a statistical significance between the two groups (p<0.005).<BR>The values of ICG R15 were 47.4±12.7% in group I and 33.2±11.0% in group II(p<0.01).In addition, a significant negative correlation between ICG R15 and portal pressure was observed in gorup I, but not in group II.<BR>In conclusion, depending on the main collaterals, the clinical manifestations of liver cirrhosis can be varied.
社団法人日本肝臓学会の論文