Hormonal and splanchnic hemodynamic alterations following hepatic resection.
Reported hemodynamic changes after partial hepatectomy (PH) include elevations in portal blood flow and pressure (Ppv). The etiology of these changes is unknown. We studied degree of portosystemic shunt (PSS), splanchnic artery blood flow and resistance (Qspl, Rspl) as well as prostacyclin (PGI2), glucagon, and insulin response in rats undergoing 75% hepatectomy. The results showed that following an immediate threefold rise in portal PGI2, a hemodynamically significant PSS developed at 48 hr. The PGI2 changes paralleled the increase in portal flow (Qpv), pressure (Ppv), PSS and the decrease in Rspl. Glucagon levels also rose immediately postresection, but fell to normal prior to resolution of both PSS and hyperemia. There was no significant change in insulin or glucose levels after resection. This implies a relationship between PSS and the release of a prostanoid effecting Qpv, Qspl, and Rspl, which relates to, and possibly mediates, the hemodynamic changes following liver resection. We conclude that PH is a model of acute PHT, and that the altered splanchnic hemodynamic could relate to hepatic regeneration.
Wu
Y
Y
Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-4665.
Campbell
K A
KA
Sitzmann
J V
JV
D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D011464:Epoprostenol / Q000097:blood; D006439:Hemodynamics; D006498:Hepatectomy; D006728:Hormones / Q000097:blood*; D007700:Kinetics; D008099:Liver / Q000098:blood supply*; D008297:Male; D008638:Mesenteric Arteries / Q000502:physiology*; D017082:Portal Pressure; D011169:Portal Vein; D051381:Rats; D017207:Rats, Sprague-Dawley; D012039:Regional Blood Flow; D014655:Vascular Resistance
D001786:Blood Glucose; D006728:Hormones; D011464:Epoprostenol