Blood flow measurement in patients with hepatocellular carcinomas.
Since the data regarding the afferent circulation of the liver in patients having primary hepatocellular carcinoma are controversial or missing. Authors carried out the measurement of hepatic arterial and portal venous flow intraoperatively by transit time ultrasonic volume flowmetry. In patients with primary hepatocellular carcinoma the hepatic artery flow increased to 0.55 +/- 0.211 compared with the control value of 0.37 +/- 0.102 1/min (p < 0.01). The portal venous flow decreased from 0.61 +/- 0.212 1/min to 0.47 +/- 1/min (p < 0.01). Due to the opposite changes in the afferent circulation the total hepatic blood flow did not change significantly. The ratio of hepatic arterial flow to portal vein flow elevated to 1.239 +/- 0.246 in patients with hepatocellular carcinoma, which is the double of the basic control value (0.66 +/- 0.259 1/min). After resection this ratio practically did not change. The surgical intervention, that is the resection of the liver did not alter the hepatic artery and portal venous flow significantly, although the total hepatic blood flow has decreased significantly (p < 0.01). The prominent and marked increase in the ratio of hepatic arterial flow may be attributed to the decrease of portal venous flow caused by the primary hepatocellular carcinoma. The decrease of venous flow can be explained most probable by compression and infiltration of the intrahepatic branches of the portal vein. As we pointed out the decrease in portal venous circulation consequently causes increase in hepatic arterial flow.(ABSTRACT TRUNCATED AT 250 WORDS)
Jakab
F
F
Department of Surgery, Semmelweis University Medical School, Budapest, Hungary.
Ráth
Z
Z
Schmal
F
F
Nagy
P
P
Faller
J
J
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006499:Hepatic Artery / Q000503:physiopathology; D006801:Humans; D007432:Intraoperative Period; D008102:Liver Circulation; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology; D012212:Rheology; D014463:Ultrasonography