Abstract
Data regarding the afferent circulation of the liver in patients with primary hepatocellular carcinoma are controversial, we have carried out measurement of hepatic arterial and portal venous flow intraoperatively by transit time ultrasonic volume flowmetry. In patients with primary hepatocellular carcinoma the hepatic artery flow increased to 0.55±0.211 compared with the control value of 0.37±0.102 1/min. (p<0.01). The portal venous flow decreased from 0.61±0.212 l/min, to 0.47±l/min. p<0.01). Due to the opposite changes in the afferent circulation the total hepatic blood flow did not change significantly, compared with controls. The ratio of hepatic arterial flow to portal vein flow increased to 1.239±0.246 in patients with hepatocellular carcinoma, which is double of the control value (0.66±0.259 l/min). After resection this ratio did not change. The resection did not alter hepatic artery or portal venous flow significantly, although the total hepatic blood flow decreased significantly (p<0.01). On the basis of our early results it is possible that the ratio of the two circulations may be to deel measured with doppler ultrasound and provide diagnostic information.
Highlights
In this study the effect of primary liver tumors and of resection were investigated on afferent hepatic cir-Many detials of the vascular patterns in liver tumors culation using ultrasonic transit time volume have been clarified, the effect of liver tumors flowmeter. (Transonic System Inc.)on afferent hepatic circulation is a porrly investigated field
In fifteen patients with hepatocellular carcinoma the average value for hepatic artery flow (HAF) was 0255+0.211 1/min. compared with the control value of 0.377+0.11 1/min. (p < 0.01). These latter values were from patients without liver cancer, ll In the same the portal venous flow (PVF) was 0.61+0.2121/ min and 0.47+0.203 1/min respectively (p < 0.01) Figure and Table 1
The blood flow in liver tumors and the circulatory changes caused by liver malignancy is ofmuch interest in surgical practice
Summary
Data regarding the afferent circulation of the liver in patients with primary hepatocellular carcinoma are controversial, we have carried out measurement of hepatic arterial and portal venous flow intraoperatively by transit time ultrasonic volume flowmetry. In patients with primary hepatocellular carcinoma the hepatic artery flow increased to 0.55+0.211 compared with the control value of 0.37+0.102 1/min. The ratio of hepatic arterial flow to portal vein flow increased to 1.239+0.246 in patients with hepatocellular carcinoma, which is double of the control value (0.66+0.259 l/min). After resection this ratio did not change. The resection did not alter hepatic artery or portal venous flow significantly, the total hepatic blood flow decreased significantly (p
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