Relationship between Portal Hemodynamics in the Remnant Liver after Hepatectomy and Changes in Liver Function

Using Doppler ultrasonography, the relationship between sequential changes in portal hemodynamics and liver function after hepatectomy was studied in 75 patients. Portal blood flow was measured in the right anterior branch or the left umbilical portion on the day before, and on the 1, 2, 3, 5, and 7th day after hepatectomy. Thirty patients developed postoperative liver dysfunction (serum total bilirubin≧2.0mg/dl ) which recovered within 14 days after surgery. In these patients, the ratios of portal velocity after surgery to that before surgery were significantly increased compared to those in 7 patients who did not recover from liver dysfunction within 14 days. In 19 of those 37 patients with liver dysfunction, the ratios were always more than 1.0, all except one patient recovered from liver dysfunction. In contrast, the ratios of the remaining 18 patients were less than 1.0 on at least one occasion during the postoperative 7 days, and 6 patients did not recovered from liver dysfunction. Five patients died of liver failure, and 3 who showed hepatopetal portal flow before surgery developed to hepatofugal flow after hepatectomy. Portal hemodynamics in the remnant liver after hepatectomy are considered to play an important role in the outcome of postoperative liver dysfunction.

門脈血行動態

ドップラー超音波診断法

肝内門脈血流速比

術後肝障害

肝切除