Peripheral portosystemic shunt and its selectivity changes measured on duplex ultrasound.
OBJECTIVE
Portosystemic shunts offer a symptomatic treatment for portal hypertension. Their main disadvantage is decreased perfusion of the liver with portal blood. Change of peripheral shunts into total shunts after a period of time is described. This study aims to evaluate long-term hemodynamic changes in peripheral portosystemic shunts.


METHODS
The study was based on 12 patients in whom distal splenorenal shunts 8 patients) and mesocaval shunts (4 patients) were indicated respectively. Duplex sonography was used to measure the blood flow in the portal, splenic and mesenteric veins before shunt surgery and minimally 14 months postoperatively.


RESULTS
It was found that the reduction of the portal blood flow was not critical and no centralization of the shunt was observed.


CONCLUSIONS
Long-term blood flow in the portal vein was not severely reduced after peripheral portosystemic shunt creation, therefore the peripheral portosystemic shunt still has a role in the treatment of some patients with portal hypertension.
Král
Vladimir
V
1st Department of Surgery, Palacky University Teaching Hospital Olomouc, Czech Republic. vladimirkral@fnol.cz
Klein
Jiri
J
Havlik
Roman
R
Vomácka
Jaroslav
J
Utikal
Petr
P
Vrba
Radek
R
D001783:Blood Flow Velocity / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D011167:Portacaval Shunt, Surgical; D011168:Portal System / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology; D013164:Splenorenal Shunt, Surgical; D013997:Time Factors; D018616:Ultrasonography, Doppler, Duplex