中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 1
Jan.  2023
Turn off MathJax
Article Contents

Hemodynamic characteristics of proper hepatic artery and portal vein in patients after splenectomy and devascularization

DOI: 10.3969/j.issn.1001-5256.2023.01.016
More Information
  • Corresponding author: ZENG Daobing, dao_zeng@aliyun.com (ORCID: 0000-0001-9675-5659)
  • Received Date: 2022-06-08
  • Accepted Date: 2022-07-20
  • Published Date: 2023-01-20
  •   Objective  To investigate the characteristics of hemodynamics of proper hepatic artery and portal vein after splenectomy and devascularization.  Methods  The clinical data of 103 patients with portal hypertension who underwent splenectomy and devascularization in the Capital Medical University-Affiliated You'an Hospital from April 2014 to February 2019 were retrospectively analyzed. Their hemodynamics of the proper hepatic artery and portal vein were recorded before and 1 week-, and 1-, 3-, 6-, 12-, and 24-months after surgery and then statistically analyzed. Continuous data with normal distribution were compared using paired-samples t test.  Results  Compared with the before surgery data, the portal vein diameter, portal vein flow, maximum velocity, and average velocity of the portal vein were all significantly decreased 1-week-, 1-, 3-, 6-, 12-, and 24-months after splenectomy and devascularization (all P < 0.05). The blood flow and velocity of the proper hepatic artery was significantly increased 1 week and 1 month after surgery (all P < 0.05); however, there was no statistically significant difference at 3-, 6-, 12-, and 24-months after surgery.  Conclusion  The diameter, flow, and flow velocity of the portal vein after splenectomy and devascularization were significantly lower than those before surgery, whereas the proper hepatic artery flow and flow velocity were increased within 1 month after surgery and then returned back to the pre-surgery levels 3 months after surgery.

     

  • loading
  • [1]
    BAO H, HE Q, DAI N, et al. Retrospective study to compare selective decongestive devascularization and gastrosplenic shunt versus splenectomy with pericardial devascularization for the treatment of patients with esophagogastric varices due to cirrhotic portal hypertension[J]. Med Sci Monit, 2017, 23: 2788-2795. DOI: 10.12659/msm.904660.
    [2]
    HUANG L, YU Q, WANG J. Association between changes in splanchnic hemodynamics and risk factors of portal venous system thrombosis after splenectomy with periesophagogastric devascularization[J]. Med Sci Monit, 2018, 24: 4355-4362. DOI: 10.12659/MSM.909403.
    [3]
    MORIYASU F, NISHIDA O, BAN N, et al. Measurement of portal vascular resistance in patients with portal hypertension[J]. Gastroenterology, 1986, 90(3): 710-717. DOI: 10.1016/0016-5085(86)91127-3.
    [4]
    ZENG DB, DAI CZ, LU SC, et al. Abnormal splenic artery diameter/hepatic artery diameter ratio in cirrhosis-induced portal hypertension[J]. World J Gastroenterol, 2013, 19(8): 1292-1298. DOI: 10.3748/wjg.v19.i8.1292.
    [5]
    YAMAUCHI H, SUDA Y, YAMAMOTO K, et al. Arteriographic studies of splenic and hepatic arteries in portal hypertension[J]. Tohoku J Exp Med, 1970, 101(4): 363-374. DOI: 10.1620/tjem.101.363.
    [6]
    GANGIREDDY VG, KANNEGANTI PC, SRIDHAR S, et al. Management of thrombocytopenia in advanced liver disease[J]. Can J Gastroenterol Hepatol, 2014, 28(10): 558-564. DOI: 10.1155/2014/532191.
    [7]
    ZUO HW, SHA QM, SUN J, et al. Risk factors of portal vein thrombosis in cirrhotic patients with esophageal varices[J]. J Clin Hepatol, 2021, 37(1): 63-67. DOI: 10.3969/j.issn.1001-5256.2019.01.001.

    左怀文, 沙启梅, 孙姣, 等. 肝硬化食管静脉曲张患者门静脉血栓形成的危险因素分析[J]. 临床肝胆病杂志, 2021, 37(1): 63-67. DOI: 10.3969/j.issn.1001-5256.2021.01.013.
    [8]
    YANG Z. Current status and perspectives of surgical treatment of portal hypertension[J]. J Clin Hepatol, 2016, 32(2): 250-253. DOI: 10.3969/j.issn.1001-5256.2021.01.013.

    杨镇. 我国门静脉高压症外科治疗的现况和展望[J]. 临床肝胆病杂志, 2016, 32(2): 250-253. DOI: 10.3969/j.issn.1001-5256.2021.01.013.
    [9]
    ZHAO XF, LIN DD, LI N, et al. Application of warfarin in dealing with portal vein thrombosis in patients with liver cirrhosis after splenectomy and devascularization[J]. J Prac Hepatol, 2019, 22(2): 240-243. DOI: 110.3969/j.issn.1672-5069.2019.02.022.

    赵晓飞, 林栋栋, 李宁, 等. 脾切除联合食管胃底曲张静脉断流术后应用华法林对门静脉血栓的防治作用[J]. 实用肝脏病杂志, 2019, 22(2): 240-243. DOI: 110.3969/j.issn.1672-5069.2019.02.022.
    [10]
    OSHITA K, OHIRA M, HONMYO N, et al. Treatment outcomes after splenectomy with gastric devascularization or balloon-occluded retrograde transvenous obliteration for gastric varices: a propensity score-weighted analysis from a single institution[J]. J Gastroenterol, 2020, 55(9): 877-887. DOI: 10.1007/s00535-020-01693-9.
    [11]
    ZENG DB, DI L, ZHANG RC, et al. The effect of splenectomy on the reversal of cirrhosis: a prospective study[J]. Gastroenterol Res Pract, 2019, 2019: 5459427. DOI: 10.1155/2019/5459427.
    [12]
    GUPTA S, POTTAKKAT B, VERMA SK, et al. Pathological abnormalities in splenic vasculature in non-cirrhotic portal hypertension: Its relevance in the management of portal hypertension[J]. World J Gastrointest Surg, 2020, 12(1): 1-8. DOI: 10.4240/wjgs.v12.i1.1.
    [13]
    ZEND DB, DI L, DING J, et al. Clinical efficacy of devascularization in treatment of esophageal and gastric varices in cirrhosis patients with portal hypertension[J/CD]. Chin J Hepat Surg(Electronic Edition), 2019, 8(4): 306-310. DOI: 10.3877/cma.j.issn.2095-3232.2019.04.007.

    曾道炳, 邸亮, 丁兢, 等. 断流术治疗肝硬化门静脉高压症食管胃静脉曲张疗[J/CD]. 中华肝脏外科手术学电子杂志, 2019, 8(4): 306-310. DOI: 10.3877/cma.j.issn.2095-3232.2019.04.007.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(8)

    Article Metrics

    Article views (1671) PDF downloads(85) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return