Clinical significance of umbilicoportal manometry.
Ninety-six adult patients had measurements of portal pressur over 1 to 5 days via indwelling extraperitoneal umbilicoportal catheters. Liver biopsy specimens obtained during catheterization showed 50 patients to have a normal liver; the remainder had liver disease. Portal pressure averaged 16.08 +/- 2.87 (SED) cm of saline in normal patients. Ten patients, 6 with cirrhotic and 4 with normal livers, were recatheterized 1.5 days to 7 months later when they came to laparotomy. In all but one, portal pressures were decreased during anesthesia and laparotomy. Twenty additional patients undergoing cholecystectomy had portal pressures measured before and after laparotomy, and after recovery from anesthesia for 1 to 3 postoperative days. Laparotomy caused a decrease in portal pressure of 2.7 +/- 1.3 (SED) cm of saline; after recovery from anesthesia portal pressure was higher by 2.5 +/- 1.7 (SED) cm of saline. Umbilicoportal catheterization is a safe and accurate technique for studying the portal system. In the intact unanesthetized state, we consider 22 cm of saline to be the upper limit of normal for portal pressure.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia; D001794:Blood Pressure; D002404:Catheterization; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011168:Portal System / Q000502:physiology*; D014471:Umbilical Veins