Effects of various surgical procedures on portal hemodynamics in patients with portal hypertension

ObjectiveTo study the effects on hemodynamics of portal venous system of splenorenal shunt plus pericardia devascularization (SRS+PCDV), and evaluate the clinical significance of this operative procedure.MethodsThe hemodynamic parameters of portal venous system by Doppler color-flow imaging (DCFI) of 99 patients with portal hypertension (PH) were measured before and after operation.Results(1)In SRS group the postoperative portal venous flow (PVF), free portal pressure(FPP) decreased by (57±9)%, (52±5)% respectively (P0.01).(2) In PCDV group PVF decreased by (8±5)% (P0.05), FPP decreased by (19±7)% (P0.05).(3)In SRS+PCDV group PVF,FPP decreased by (36±8)%, (34±10)% respectively(P0.05). (4)The postoperative decrease of PVF and FPP in SRS+PCDV group were between that of SRS and PCDV groups and the difference among the groups was statistically significant (P0.05).Conclusions(1) The portal blood stasis remained in patients undergoing devascularization. (2) The congestive status of portal vein relieved after SRS, but the hepatic perfusion from portal vein decreased significantly.(3) SRS+PCDV decreases PVF and FPP moderately and effects a significant decrease in recurrent bleeding rate.