[The clinical study of systemic hemodynamics after partial hepatectomy, with special reference to cirrhotic subjects]

To elucidate the pathophysiological role of partial hepatectomy on systemic hemodynamics, general hemodynamics were investigated in 29 patients pre and postoperatively. Twenty-five patients with smooth postoperative course were divided into two groups, non-cirrhotic (n = 15) and cirrhotic (n = 10). On the first postoperative day (p.o.d.), cardiac index (CI) increased significantly but arteriovenous oxygen content difference (C(a-v)O2) didn't increase in non-cirrhotics. While, increased in cirrhotics, CI increased only mildly and C(a-v)O2 increased. In both groups oxygen consumption (VO2) increased significantly. Since these characteristic pattern in cirrhotics were even clearer in patients with lower functional reserve of remnant liver, it was suggested that cardiac function was suppressed under decreased functional reserve of remnant liver. Four cirrhotics fell into hepatic failure during early postoperative period. On the first p.o.d., CI and C(a-v)O2 of these patients didn't increased, and VO2 decreased slightly. On the second p.o.d., CI increased but C(a-v)O2 and VO2 decreased extremely. It seemed likely that these disturbance of oxygen uptake and consumption affected function of remnant liver considerably.