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Effects of laparoscopic pericardial devascularization on hemodynamics of the portal venous system and hepatic artery
Sun Yibo, Yin Jikai, Dong Rui, Li Zhi, Wang Dong, Huang Bo, Yang Yuan, Lu Jianguo
Journal of Abdominal Surgery ›› 2019, Vol. 32 ›› Issue (2) : 94-98.
PDF(1539 KB)
PDF(1539 KB)
Effects of laparoscopic pericardial devascularization on hemodynamics of the portal venous system and hepatic artery
Objective To investigate the effects of laparoscopic splenectomy plus pericardial devascularization on hemodynamics of the portal venous system and hepatic artery.Methods A total of 270 patients with portal hypertension admitted to the Department of General Surgery of the Second Affiliated Hospital of Air Force Military Medical University from January 2011 to December 2017 were retrospectively analyzed. All patients underwent laparoscopic splenectomy plus pericardial devascularizationn. The differences in diameter, blood flow velocity, and blood flow between the portal vein, superior mesenteric vein, and hepatic artery before and after surgery were observed and compared. Results ①Hemodynamic changes of portal vein system:Our data exhibited that the diameter, the blood flow velocity and the blood flow of portal vein were significantly reduced after surgery (P<0.001). The diameter of superior mesenteric vein decreased significantly (P<0.001). There was no difference observed in the velocity of superior mesenteric vein (P=0.915). The mean blood flow volume of superior mesenteric vein was reduced after surgery, but no significant difference was identified (P=0.065). ②A marked increase in hepatic artery diameter was observed(P=0.001). The maximum blood flow velocity, minimum blood flow velocity and mean blood flow velocity of the hepatic artery all significantly increased after the operation (P<0.01). The Hepatic artery blood flow were also increased significantly (P=0.02). Conclusion With regard to the hemodynamic changes, laparoscopic splenectomy plus pericardial devascularization can significantly improve the hyperdynamic circulatory state of the portal venous system without affecting the venous reflux of the digestive tract while can significantly improve the hepatic arterial perfusion, which has positive clinical implication for the prognosis of portal hypertension.
Portal hypertension / Laparoscopic / Splenectomy / Pericardial devascularization / Hemodynamics {{custom_keyword}} /
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