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Recovery of portal blood flow after percutaneous transhepatic biliary drainage in patients with obstructive jaundice

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Abstract

Using an ultrasonic Doppler system, we prospectively studied the changes in portal venous flow (PVF) following percutaneous transhepatic biliary drainage (PTBD) and evaluated the correlation between PVF and liver function in 10 patients with obstructive jaundice. The patients were divided into two groups according to their rate of decrease in serum bilirubin (“b”). Group A comprised 5 patients with a “b” of less than −0.1, while group B consisted of 5 patients who did not meet this criterion. The mean PVF increased following PTBD (P<0.01). The increase in PVF was due to an increase in the maximum velocity of the portal vein (Vmax). The rate of increase in the Vmax in group A was significantly higher than that in group B on both the 7th and 14th postdrainage days (P<0.05). The rate of increase in the Vmax correlated significantly with the rate of decrease in the serum bilirubin concentration (P<0.01). Based on the above findings, we conclude that measuring the Vmax by Doppler ultrasonography is useful in evaluating the liver function in patients with obstructive jaundice.

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References

  1. Aronsen KF, Nylander G, Ohlsson EG (1969) Liver blood flow studies during and after various periods of total biliary obstruction in the dog. Acta Chir Scand 135:55–59

    CAS  PubMed  Google Scholar 

  2. Hunt DR (1979) Changes in liver blood flow with development of biliary obstruction in the rat. Aust NZ J Surg 49:733–737

    CAS  Google Scholar 

  3. Bosch J, Enriquez R, Groszman RJ, Storer EH (1983) Chronic bile duct ligation in the dog: hemodynamic characterization of a portal hypertensive model. Hepatology 3:1002–1007

    CAS  PubMed  Google Scholar 

  4. Mathie RT, Nagorney DM, Lewis MH, Blumgart LH (1988) Hepatic hemodynamics after chronic obstruction of the biliary tract in the dog. Surg Gynecol Obstet 166:125–130

    CAS  PubMed  Google Scholar 

  5. Kodama O, Fujii Y, Tanaka T, Nakatsuka H, Ichiba Y, Miura Y, Dohi K (1990) Experimental and clinical studies on liver tissue blood flow in obstructive jaundice (in Japanese with English abstract). Nippon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 87:49–56

    CAS  PubMed  Google Scholar 

  6. Moriyasu F, Ban N, Nishida O, Nakamura T, Miyake T, Uchino H, Kanematsu K, Koizumi S (1986) Clinical application of an ultrasonic duplex system in the quantitative measurement of portal blood flow. JCU 14:579–588

    CAS  PubMed  Google Scholar 

  7. Kin Y, Nimura Y, Hayakawa N, Kamiya J, Kondo S, Nagino M, Miyachi M, Kanai M (1994) Doppler analysis of hepatic blood flow predicts liver dysfunction after major hepatectomy. World J Surg 18:143–149

    Article  CAS  PubMed  Google Scholar 

  8. Koyama K, Takagi Y, Ito K, Sato T (1981) Experimental and clinical studies on the effect of biliary drainage in obstructive jaundice. Am J Surg 42:293–299

    Google Scholar 

  9. Shimizu T, Yoshida K, Muto T (1979) Classification of obstructive jaundice based on the bilirubin decreasing rate “b” and its clinical significance (in Japanese with English abstract). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 80:93–97

    Google Scholar 

  10. Rizzo RJ, Sandager G, Astleford P, Payne K, Peterson-Kennedy L, Flinn WR, Yao JST (1990) Mesenteric flow velocity variations as a function of angle of insonation. J Vasc Surg 11:688–694

    CAS  PubMed  Google Scholar 

  11. Szabo G, Jakab F, Magyar Z (1974) Effect of acute cholestasis on hepatic circulation. Acta Med Acad Sci Hung 31:229–239

    CAS  PubMed  Google Scholar 

  12. Tamakuma S, Wada N, Ishiyama M, Suzuki H, Kaneyama T, Okinaga K, Isoyama T, Sugahara K, Ishiyama K (1975) Relationship between hepatic hemodynamics and biliary pressure in dogs: its significance in clinical shock following biliary decompression. Jpn J Surg 5:255–268

    CAS  PubMed  Google Scholar 

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Kanda, H., Nimura, Y., Yasui, A. et al. Recovery of portal blood flow after percutaneous transhepatic biliary drainage in patients with obstructive jaundice. Surg Today 27, 120–123 (1997). https://doi.org/10.1007/BF02385899

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  • DOI: https://doi.org/10.1007/BF02385899

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