Portal flow and hepatic function after splenectomy and esophagogastric devascularization
Related Experiment Video
Updated: Jun 16, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Darcy L M Carvalho1, Armando Capua, Pedro L S Leme
1Surgery Department, Santa Casa São Paulo Faculty of Medical Sciences, São Paulo, Brazil. lauga@terra.com.br
Abstract:
We studied 27 patients who had mansonic schistosomiasis and portal hypertension with previous episodes of digestive bleeding from esophageal varices. According to the routine of the Liver and Portal Hypertension Unit of the Faculty of Medical Sciences-Santa Casa de São Paulo, these patients underwent surgical treatment that consisted of azygoportal disconnection and splenectomy. The goal of this study was to analyze the developmental profile of portal flow and hepatic function using Doppler ultrasound and the Child-Turcotte-Pugh criteria, respectively, in the pre- and postoperatory stages, in a 3-year period. The results showed a significant 27% reduction of the portal blood flow in the recent postoperatory period and up to 37% in the first to the second year after surgery, remaining stable after this period. We observed that all patients presented with good hepatic functional reserve in the preoperatory period, with no hepatic alteration in the postoperatory period. We conclude that, despite the reduction of portal flow in response to surgery, there was no deterioration of hepatic function.
Related Concept Videos
Hepatic Portal System
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is responsible...
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Esophageal Varices-I: Introduction
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Portal Hypertension
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

