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Functional hepatic flow can predict the hepatic reserve function in surgical cirrhotic patients

Wu Xingjiang1, Ding Weiwei, Cao Jianmin

  • 1Research Institute of General Surgery, School of Medicine, Nanjing University, Jinling Hospital, Nanjing, Jiangsu Province, China. wuxingjiang@gmail.com

Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research
|May 26, 2009
PubMed

Insights

Monitoring functional hepatic flow (FHF) in cirrhotic patients helps predict hepatic reserve function after surgical treatments. FHF changes vary significantly based on specific surgical interventions like TIPS.

Area of Science:

  • Hepatology
  • Surgical Gastroenterology
  • Medical Imaging

Background:

  • Cirrhosis significantly impacts hepatic reserve function.
  • Portal hypertension is a common complication in cirrhotic patients.
  • Surgical interventions aim to manage complications of portal hypertension.

Purpose of the Study:

  • To evaluate hepatic reserve function in cirrhotic patients undergoing surgery.
  • To monitor functional hepatic flow (FHF) as an indicator of hepatic reserve.
  • To correlate FHF changes with different surgical treatments for portal hypertension.

Main Methods:

  • Thirty-seven cirrhotic patients (Child-Pugh A, B, C) and 10 healthy volunteers were studied.
  • Patients underwent various surgical procedures including Transjugular Intrahepatic Portosystemic Shunt (TIPS) and portal-azygous disconnection.
  • Functional hepatic flow (FHF) and total hepatic flow (THF) were measured using D-sorbitol clearance and Doppler sonography; portal pressure was catheterized.

Main Results:

  • Cirrhotic patients exhibited reduced FHF and increased portal blood flow, hepatic artery flow, and THF compared to controls.
  • Portal pressure and FHF decreased post-TIPS and after combined TIPS/disconnection or disconnection/shunt procedures.
  • FHF showed a significant decrease in patients treated with TIPS compared to other surgical groups.

Conclusions:

  • Monitoring FHF is valuable for predicting hepatic reserve function in cirrhotic patients.
  • Different surgical operations result in distinct changes in FHF.
  • FHF monitoring can guide clinical decisions for surgical management of cirrhotic patients.
Abstract

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