HEMODYNAMIC CHANGES IN THE PORTAL SYSTEM AFTER DISTAL SPLENORENAL SHUNT
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概要
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Hemodynamic changes in the portal system after distal splenorenal shunt were evaluated by visceral angiography in 56 patients in the early postoperative period and 22 patients in the late postoperative period. These patients consisted of the following three groups: those with Warren's procedure, those with incomplete splenopancreatic disconnection of the splenic vein (SPD) and those with complete SPD. The following results were obtained. (1) The diameter of the portal vein and the portal pressure were significantly decreased in all three groups. (2) In the early postoperative period, portal vein perfusion was well maintained in all three groups. Hepatofugal collaterals for the shunt developed to a significantly greater extent in the Warren's procedure group. However, the development of these collaterals was satisfactorily prevented in complete SPD group. (3) In the late postoperative period, patients who underwent Warren's procedure had developed numerous collaterals and a decrease in portal vein perfusion. In contrast, portal vein perfusion was satisfactorily maintained in the complete and incomplete SPD groups, in spite of the incompleteness of the procedure to prevent the development of collaterals. It was concluded, therefore, that the Warren's procedure resulted in many more hemodynamic changes in the portal system in the late postoperative period, whereas SPD was suitable for the prevention of portal vein perfusion.
- 日本臨床外科学会の論文
日本臨床外科学会 | 論文
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