Portal flow and hepatic function after splenectomy and esophagogastric devascularization.
We studied 27 patients who had mansonic schistosomiasis and portal hypertension with previous episodes of digestive bleeding from esophageal varices. According to the routine of the Liver and Portal Hypertension Unit of the Faculty of Medical Sciences-Santa Casa de São Paulo, these patients underwent surgical treatment that consisted of azygoportal disconnection and splenectomy. The goal of this study was to analyze the developmental profile of portal flow and hepatic function using Doppler ultrasound and the Child-Turcotte-Pugh criteria, respectively, in the pre- and postoperatory stages, in a 3-year period. The results showed a significant 27% reduction of the portal blood flow in the recent postoperatory period and up to 37% in the first to the second year after surgery, remaining stable after this period. We observed that all patients presented with good hepatic functional reserve in the preoperatory period, with no hepatic alteration in the postoperatory period. We conclude that, despite the reduction of portal flow in response to surgery, there was no deterioration of hepatic function.
Carvalho
Darcy L M
DL
Surgery Department, Santa Casa São Paulo Faculty of Medical Sciences, São Paulo, Brazil. lauga@terra.com.br
Capua
Armando
A
Leme
Pedro L S
PL
D001783:Blood Flow Velocity; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D008099:Liver / Q000503:physiopathology*; D011168:Portal System / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D011184:Postoperative Period; D012555:Schistosomiasis mansoni / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D013156:Splenectomy; D013162:Splenic Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D018608:Ultrasonography, Doppler