[Hemodynamics of portal system using color ultrasonography and direct pressure measurement before and after...

Controlled study on the portal hemodynamics was carried out before and after pericardial devascularization in 23 patients with portal hypertension. Color ultrasonography detected LGV in 87% of the patients, total prehepatic shunt volume was larger than 46.92%, That through SV more than 15. 48%, and LGV about 15.97%. Hence the total volume shunted through gastrosplenic region was more than 31.45%. Postoperative FPP was significantly decreased (P < 0.05) and SOPP and gastris wall venous pressure increased (P < 0.01). Postoperative PVF did not change significantly. When the ratio of SAV to SVF was less than 1.0, postoperative PVF was significantly increased (P < 0.05). Shunt surgery is the treatment of choice. In the case when the ratio in larger than 1.0, PVF may, decrease (P < 0.01); Patients should receive devascularization. When SVF plus SMVF is greater than PVF, patients should be operated on only with splenectomy or devascularization.