Changes in portal hemodynamics and hepatic function after partial splenic embolization (PSE) and percutaneous transhepatic obliteration (PTO).
Since April 1985, we have performed a multidisciplinary therapy consisting of partial splenic embolization (PSE), percutaneous transhepatic obliteration (PTO) or transileocolic vein obliteration (TIO), and endoscopic injection sclerotherapy (EIS) for patients with severe gastroesophageal varices and those with a portacaval shunt associated with portal hypertension. In this study, PSE and percutaneous transhepatic portography (PTP) were performed at the same time in seven liver cirrhosis patients with hypersplenism, gastroesophageal varices, or hepatocellular carcinoma. The changes in portal blood flow/pressure and hemodynamics were examined by a thermodilution method. The effects of PSE on blood biochemical parameters such as the platelet count, ICG R15, redox tolerance index (RTI), and oral glucose tolerance test (75 g OGTT) were also evaluated. PSE induced a decrease in the blood flow of the splenic artery and in the splenic vein pressure without decreasing the portal blood flow. The platelet count in the peripheral blood and the RTI increased significantly. These results suggest the possibility that PSE may reduce the potential perioperative risk in hepatocellular carcinoma complicated with liver cirrhosis.
Mukaiya
M
M
First Department of Surgery, Sapporo Medical University, Japan.
Hirata
K
K
Yamashiro
K
K
Katsuramaki
T
T
Kimura
H
H
Denno
R
R
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000628:therapy*; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D010976:Platelet Count; D017082:Portal Pressure; D013152:Splanchnic Circulation; D013154:Spleen / Q000098:blood supply*