[Portal hemodynamic changes from partial hepatectomy--quantitative analysis of portal flow before, during and after...

We investigated portal hemodynamic changes in 86 patients with hepatic tumors who underwent partial hepatectomy. Portal blood flow was measured using a sector type Doppler ultrasound system before, during and after operation. In the intraoperative studies, the portal flow in patients who underwent massive liver resection decreased significantly. On the other hand, the portal flow in patients with minor liver resection tended to increase, but not significantly. Overall, portal flow per unit of cardiac out put decreased significantly; it also decreased significantly in patients who underwent massive or major liver resection, in patients with liver cirrhosis, and in patients whose post operative clinical course was satisfactory. In the post-operative studies (10-12 days after surgery), the portal blood flow decreased significantly in patients who manifested a severe post-operative clinical course; it showed no significant change in other patients. It is thus essential to monitor the portal hemodynamics of partial-hepatectomy patients. This is most readily realized using Doppler ultrasound.