Mesocaval and distal splenorenal shunts: Effect on hepatic function, hepatic hemodynamics, and portal systemic encephalopathy
| العنوان: | Mesocaval and distal splenorenal shunts: Effect on hepatic function, hepatic hemodynamics, and portal systemic encephalopathy |
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| المؤلفون: | R. Herz, Wolfgang Gerok, D. Waldmann, M. Rössle, H. J. Halbfaß |
| المصدر: | Klinische Wochenschrift. 63:409-418 |
| بيانات النشر: | Springer Science and Business Media LLC, 1985. |
| سنة النشر: | 1985 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Portal venous pressure, Hemodynamics, Esophageal and Gastric Varices, Gastroenterology, Hepatic function, Postoperative Complications, Esophageal varices, Liver Function Tests, Internal medicine, Drug Discovery, medicine, Humans, Portasystemic Shunt, Surgical, Amino Acids, Genetics (clinical), Portacaval Shunt, Surgical, business.industry, General Medicine, Blood flow, Middle Aged, medicine.disease, Portal systemic encephalopathy, Blood Vessel Prosthesis, Shunt (medical), Hepatic Encephalopathy, Molecular Medicine, Portal hypertension, Female, Gastrointestinal Hemorrhage, business, Splenorenal Shunt, Surgical, Liver Circulation |
| الوصف: | The effect of the mesocaval interposition shunt (n = 12) and the distal splenorenal shunt (n = 9) on the wedged hepatic venous pressure, the estimated hepatic blood flow, quantitative hepatic function, and the rate of portal systemic encephalopathy was evaluated in 21 patients who had bled from esophageal varices. After mesocaval shunt the wedged hepatic venous pressure was significantly reduced by 42% (from 26 +/- 3 mm Hg to 15 +/- 5 mm Hg, P less than 0.001) compared to 16% only (from 25 +/- 3 mm Hg to 21 +/- 2 mm Hg, P less than 0.005) after distal splenorenal shunt. The estimated hepatic blood flow also decreased significantly after mesocaval shunt by 61% (from 1.45 +/- 0.46 l/min to 0.56 +/- 0.25 l/min, P less than 0.001) compared to 29% (from 1.29 +/- 0.32 l/min to 0.91 +/- 0.39 l/min, P less than 0.05) after distal splenorenal shunt. Despite significantly different influences of both types of shunt operations on wedged hepatic venous pressure and estimated hepatic blood flow (P less than 0.001), postoperative changes of hepatic function were comparable in both groups of patients. The galactose elimination capacity, the initial plasma disappearance rate of Bromsulphalein, and the plasma ratio of valine, leucine, and isoleucine to phenylalanine and tyrosine were reduced by 13%, 26%, and 29%, respectively, after mesocaval shunt, compared to 12%, 25%, and 17% after distal splenorenal shunt. Only two patients of the mesocaval shunt group with the largest decrease in estimated hepatic blood flow developed portal systemic encephalopathy postoperatively, and the distal splenorenal shunt patients with their minor hemodynamic sequelae remained free of portal systemic encephalopathy. |
| تدمد: | 1432-1440 0023-2173 |
| DOI: | 10.1007/bf01733666 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::977fe91dd89c321d7bc7c313de348eea https://doi.org/10.1007/bf01733666 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....977fe91dd89c321d7bc7c313de348eea |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321440 00232173 |
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| DOI: | 10.1007/bf01733666 |