Skip to main content
SpringerLink
Log in

Portal blood flow via the peribiliary vascular plexus demonstrated by contrast-enhanced ultrasonography with Sonazoid

  • Technical note
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Purpose

We report two cases in which portal blood flow via the peribiliary vascular plexus (PBP) was clearly demonstrated using contrast-enhanced intra-operative ultrasonography (CE-IOUS).

Methods

Two patients who underwent hemihepatectomies were investigated using CE-IOUS. Before injection of the contrast medium, both the hepatic arterial and portal venous flows of the hemiliver to be resected were interrupted by ligating those corresponding vessels at the hepatic hilum. Subsequently, the perfluorobutane microbubbles were injected intravenously.

Results

In the early vascular phase, a remarkable intermittent flow was visualized in the lumen of the portal branches whose inflows were interrupted. The flow of the portal vein then disappeared as a result of ligating the hepatic duct concomitantly with the surrounding connective tissue. We considered that the portal venous flow appearing under the condition of total disruption of original inflow was supplied from the hepatic artery through the PBP.

Conclusions

This is the first report of blood flow via the PBP in human liver visualized by dynamic image study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Nakanuma Y, Hoso M, Sanzen T, Sasaki M. Microstructure and development of the normal and pathologic biliary tract in humans, including blood supply. Microsc Res Tech. 1997;38:552–70.

    Article  PubMed  CAS  Google Scholar 

  2. Cho KJ, Lunderquist A. The peribiliary vascular plexus: the microvascular architecture of the bile duct in the rabbit and in clinical cases. Radiology. 1983;147:357–64.

    PubMed  CAS  Google Scholar 

  3. Mitra SK. The terminal distribution of the hepatic artery with special reference to arterio-portal anastomosis. J Anat. 1966;100:651–63.

    PubMed  CAS  Google Scholar 

  4. Kan Z, Ivancev K, Lunderquist A. Peribiliary plexa—important pathways for shunting of iodized oil and silicon rubber solution from the hepatic artery to the portal vein. An experimental study in rats. Invest Radiol. 1994;29:671–6.

    Article  PubMed  CAS  Google Scholar 

  5. Kobayashi S, Nakanuma Y, Matsui O. Intrahepatic peribiliary vascular plexus in various hepatobiliary diseases: a histological survey. Hum Pathol. 1994;25:940–6.

    Article  PubMed  CAS  Google Scholar 

  6. Matsunaga Y, Terada T. Peribiliary capillary plexus around interlobular bile ducts in various chronic liver diseases: an immunohistochemical and morphometric study. Pathol Int. 1999;49:869–73.

    Article  PubMed  CAS  Google Scholar 

  7. Gaudio E, Onori P, Pannarale L, Alvaro D. Hepatic microcirculation and peribiliary plexus in experimental biliary cirrhosis: a morphological study. Gastroenterology. 1996;111:1118–24.

    Article  PubMed  CAS  Google Scholar 

  8. Sano K, Makuuchi M, Miki K, Maema A, Sugawara Y, Imamura H, et al. Evaluation of hepatic venous congestion: proposed indication criteria for hepatic vein reconstruction. Ann Surg. 2002;236:241–7.

    Article  PubMed  Google Scholar 

  9. Sofuni A, Iijima H, Moriyasu F, Nakayama D, Shimizu M, Nakamura K, et al. Differential diagnosis of pancreatic tumors using ultrasound contrast imaging. J Gastroenterol. 2005;40:518–25.

    Article  PubMed  Google Scholar 

  10. Tohma T, Cho A, Okazumi S, Makino H, Shuto K, Mochiduki R, et al. Communicating arcade between the right and left hepatic arteries: evaluation with CT and angiography during temporary balloon occlusion of the right or left hepatic artery. Radiology. 2005;237:361–5.

    Article  PubMed  Google Scholar 

  11. Terada T, Ishida F, Nakanuma Y. Vascular plexus around intrahepatic bile ducts in normal livers and portal hypertension. J Hepatol. 1989;8:139–49.

    Article  PubMed  CAS  Google Scholar 

  12. Gülberg V, Haag K, Rössle M, Gerbes AL. Hepatic arterial buffer response in patients with advanced cirrhosis. Hepatology. 2002;35:630–4.

    Article  PubMed  Google Scholar 

  13. Rocheleau B, Ethier C, Houle R, Huet PM, Bilodeau M. Hepatic artery buffer response following left portal vein ligation: its role in liver tissue homeostasis. Am J Physiol. 1999;277(5 Pt 1):G1000-7.

    Google Scholar 

  14. Kollmar O, Corsten M, Scheuer C, Vollmar B, Schilling MK, Menger MD. Portal branch ligation induces a hepatic arterial buffer response, microvascular remodeling, normoxygenation, and cell proliferation in portal blood-deprived liver tissue. Am J Physiol Gastrointest Liver Physiol. 2007;292:G1534–42.

    Article  PubMed  CAS  Google Scholar 

  15. Ezzat WR, Lautt WW. Hepatic arterial pressure-flow autoregulation is adenosine mediated. Am J Physiol. 1987;252:H836–45.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan

    Yuji Uchikawa & Shin-ichi Miyagawa

  2. Department of Surgery, Matsumoto Medical Center, Matsumoto Hospital, 1209 Yoshikawa-murai, Matsumoto, Nagano, 399-8701, Japan

    Hiroshi Kitamura

Authors
  1. Yuji Uchikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroshi Kitamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shin-ichi Miyagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shin-ichi Miyagawa.

About this article

Cite this article

Uchikawa, Y., Kitamura, H. & Miyagawa, Si. Portal blood flow via the peribiliary vascular plexus demonstrated by contrast-enhanced ultrasonography with Sonazoid. J Hepatobiliary Pancreat Sci 18, 615–620 (2011). https://doi.org/10.1007/s00534-011-0380-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-011-0380-y

Keywords

Search

Navigation