Ultrasonic Doppler duplex study of hemodynamic changes from portosystemic shunt operation.

Abstract

The portal hemodynamics were studied in ten patients with portal hypertension, including three patients who had interposition mesocaval shunt (IMCS), three patients who had distal splenorenal shunt (DSRS), one patient who had gastrocaval shunt (GCS), and three patients who had splenectomy. Portal blood flow was measured by an ultrasonic Doppler duplex system, and portal venous pressure was measured by portal catheterization before, during, and after operation. The portal blood flow, and especially the splenic venous blood flow, was less during operation than before operation. Blood flow through the IMCS was greater than that through the DSRS, and the shunt flow had a tendency to increase after operation. The portal venous pressure measured during operation was slightly higher than that measured percutaneously before operation. In the patients who had the shunt operation, the portal venous pressure tended to decrease after operation. Study of portal hemodynamics, especially with the ultrasonic Doppler method, is useful in analysis and follow-up of patients who have shunt operations since the same method can be used before, during, and after operation.