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Long-Term Hemodynamic Effects of Portocaval Shunt and Sugiura Procedure in Patients with Cirrhosis

Systemic and splanchnic hemodynamics were studied before and six months after a portal systemic shunt (n=6) or a Sugiura procedure (n=9) in 15 patients with cirrhosis and a past history of variceal bleeding. Hepatic blood flow was estimated by hepatic extraction and clearance of continuous indocyani...

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Autores principales: Vons, Corinne, Hadengue, Antoine, Smadja, Claude, Franco, Dominique, Lebrec, Didier
Formato: Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 1996
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2443776/
https://www.ncbi.nlm.nih.gov/pubmed/8809580
http://dx.doi.org/10.1155/1996/46476
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author Vons, Corinne
Hadengue, Antoine
Smadja, Claude
Franco, Dominique
Lebrec, Didier
author_facet Vons, Corinne
Hadengue, Antoine
Smadja, Claude
Franco, Dominique
Lebrec, Didier
author_sort Vons, Corinne
collection PubMed
description Systemic and splanchnic hemodynamics were studied before and six months after a portal systemic shunt (n=6) or a Sugiura procedure (n=9) in 15 patients with cirrhosis and a past history of variceal bleeding. Hepatic blood flow was estimated by hepatic extraction and clearance of continuous indocyanine green infusion. Azygos blood flow was measured with a continuous thermodilution catheter. After portocaval shunt, the cardiac index increased significantly from 4.0±1.4 to 5.4±0.8 l/min m2 (p<0.05), the hepatic venous pressure gradient and hepatic blood flow were significantly decreased from 21±3 to 13±5 mm Hg (p<0.05) and from 1.20±0.35 to 0.37±0.16 l/min (p<0.05) respectively. The decrease in azygos blood flow was not significant (0.51±0.31 vs 0.25±0.33 l/min; p=0.1). After Sugiura procedure, there was no significant change in cardiac index, hepatic venous pressure gradient, hepatic blood flow or azygos blood flow. This is the first study to show the long-term maintenance of splanchnic and systemic hemodynamics in patients with cirrhosis after Sugiura procedure. The absence of long-term hemodynamic alterations could explain the absence of encephalopathy after this procedure.
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spelling pubmed-24437762008-07-08 Long-Term Hemodynamic Effects of Portocaval Shunt and Sugiura Procedure in Patients with Cirrhosis Vons, Corinne Hadengue, Antoine Smadja, Claude Franco, Dominique Lebrec, Didier HPB Surg Research Article Systemic and splanchnic hemodynamics were studied before and six months after a portal systemic shunt (n=6) or a Sugiura procedure (n=9) in 15 patients with cirrhosis and a past history of variceal bleeding. Hepatic blood flow was estimated by hepatic extraction and clearance of continuous indocyanine green infusion. Azygos blood flow was measured with a continuous thermodilution catheter. After portocaval shunt, the cardiac index increased significantly from 4.0±1.4 to 5.4±0.8 l/min m2 (p<0.05), the hepatic venous pressure gradient and hepatic blood flow were significantly decreased from 21±3 to 13±5 mm Hg (p<0.05) and from 1.20±0.35 to 0.37±0.16 l/min (p<0.05) respectively. The decrease in azygos blood flow was not significant (0.51±0.31 vs 0.25±0.33 l/min; p=0.1). After Sugiura procedure, there was no significant change in cardiac index, hepatic venous pressure gradient, hepatic blood flow or azygos blood flow. This is the first study to show the long-term maintenance of splanchnic and systemic hemodynamics in patients with cirrhosis after Sugiura procedure. The absence of long-term hemodynamic alterations could explain the absence of encephalopathy after this procedure. Hindawi Publishing Corporation 1996 /pmc/articles/PMC2443776/ /pubmed/8809580 http://dx.doi.org/10.1155/1996/46476 Text en Copyright © 1996 Hindawi Publishing Corporation. http://creativecommons.org/licenses/by/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Vons, Corinne
Hadengue, Antoine
Smadja, Claude
Franco, Dominique
Lebrec, Didier
Long-Term Hemodynamic Effects of Portocaval Shunt and Sugiura Procedure in Patients with Cirrhosis
title Long-Term Hemodynamic Effects of Portocaval Shunt and Sugiura Procedure in Patients with Cirrhosis
title_full Long-Term Hemodynamic Effects of Portocaval Shunt and Sugiura Procedure in Patients with Cirrhosis
title_fullStr Long-Term Hemodynamic Effects of Portocaval Shunt and Sugiura Procedure in Patients with Cirrhosis
title_full_unstemmed Long-Term Hemodynamic Effects of Portocaval Shunt and Sugiura Procedure in Patients with Cirrhosis
title_short Long-Term Hemodynamic Effects of Portocaval Shunt and Sugiura Procedure in Patients with Cirrhosis
title_sort long-term hemodynamic effects of portocaval shunt and sugiura procedure in patients with cirrhosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2443776/
https://www.ncbi.nlm.nih.gov/pubmed/8809580
http://dx.doi.org/10.1155/1996/46476
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