[Measurement of the portal blood flow in man by continuous local thermodilution method: II. Portal hemodynamics before and after hepatectomy].
We found that measurements of portal blood flow by continuous thermodilution were highly reproducible even after hepatectomy. Our subjects numbered 59 in all: In these patients having diseases of the liver and biliary tract, we studied portal hemodynamics during percutaneous transhepatic portography. Of these, 37 underwent hepatectomy. We chose 19 subjects from this group, and measured again both portal venous flow and portal venous pressure many times, continuing for 14 more days. In all 19 patients checked after hepatectomy, portal hemodynamics became hypodynamic, and this change was greater when the amount of liver resected was large. In 18 of these patients, hemodynamics started to improve after the 7th postoperative day. Changes in hemodynamics were not significantly different in patients with or without cirrhosis. In one patient who died of hepatic failure, the portal hypodynamic state did not improve. With this exception, in patients with major resections, portal venous flow per liver volume had increased after surgery and continued to increase. This was not true for patients with minor resections. Portal hemodynamics are important in the functioning and regeneration of the remaining liver, and it is necessary to understand and medically correct portal hemodynamics before and after hepatectomy.
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006439:Hemodynamics; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000503:physiopathology; D008113:Liver Neoplasms / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000503:physiopathology*; D012039:Regional Blood Flow; D013815:Thermodilution / Q000379:methods