Effects of non-shunting operation on azygos venous blood flow in cirrhotic patients
Azygos venous blood flow and other haemodynamic parameters were measured in 14 cirrhotic patients to investigate the effects of a non-shunting operation, oesophageal transection with paraoesophagogastric devascularisation. Azygos venous blood flow measured by the local continuous thermal dilution me...
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| Published in | Gut Vol. 30; no. 10; pp. 1396 - 1400 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BMJ Publishing Group Ltd and British Society of Gastroenterology
01.10.1989
BMJ BMJ Publishing Group LTD |
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| Abstract | Azygos venous blood flow and other haemodynamic parameters were measured in 14 cirrhotic patients to investigate the effects of a non-shunting operation, oesophageal transection with paraoesophagogastric devascularisation. Azygos venous blood flow measured by the local continuous thermal dilution method was significantly reduced by 13.8% after the operation (428 (41) v 369 (33) ml/min). Hepatic venous pressure gradient (HVPG) was also significantly decreased from 14.5 (0.8) to 12.8 (0.7) mmHg (-11.8%). Cardiac output and routine liver tests did not change remarkably postoperatively. In this haemodynamic study before and after non-shunting operation, moderate but significant decreases were seen in azygos venous blood flow and portal pressure (HVPG), without substantial changes in systemic circulation. This suggests that blood flow through the portosystemic collaterals other than oesophageal varices may be decreased but still adequate after the operation. Well preserved portosystemic collaterals without oesophageal varices are thus considered an optimally balanced state after non-shunting operation. |
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| AbstractList | Azygos venous blood flow and other haemodynamic parameters were measured in 14 cirrhotic patients to investigate the effects of a non-shunting operation, oesophageal transection with paraoesophagogastric devascularisation. Azygos venous blood flow measured by the local continuous thermal dilution method was significantly reduced by 13.8% after the operation (428 (41) v 369 (33) ml/min). Hepatic venous pressure gradient (HVPG) was also significantly decreased from 14.5 (0.8) to 12.8 (0.7) mmHg (-11.8%). Cardiac output and routine liver tests did not change remarkably postoperatively. In this haemodynamic study before and after non-shunting operation, moderate but significant decreases were seen in azygos venous blood flow and portal pressure (HVPG), without substantial changes in systemic circulation. This suggests that blood flow through the portosystemic collaterals other than oesophageal varices may be decreased but still adequate after the operation. Well preserved portosystemic collaterals without oesophageal varices are thus considered an optimally balanced state after non-shunting operation. |
| Author | Kokudo, N Idezuki, Y Ohashi, K Koyama, H Sanjo, K Sakamoto, H Kawasaki, S |
| AuthorAffiliation | Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan |
| AuthorAffiliation_xml | – name: Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan |
| Author_xml | – sequence: 1 givenname: N surname: Kokudo fullname: Kokudo, N – sequence: 2 givenname: S surname: Kawasaki fullname: Kawasaki, S – sequence: 3 givenname: K surname: Ohashi fullname: Ohashi, K – sequence: 4 givenname: H surname: Sakamoto fullname: Sakamoto, H – sequence: 5 givenname: H surname: Koyama fullname: Koyama, H – sequence: 6 givenname: K surname: Sanjo fullname: Sanjo, K – sequence: 7 givenname: Y surname: Idezuki fullname: Idezuki, Y |
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| Cites_doi | 10.1001/archsurg.1977.01370110051005 10.1016/S0022-5223(19)40560-6 10.1002/hep.1840040617 10.1161/01.CIR.44.2.181 10.1097/00000658-197204000-00002 10.1016/S0016-5085(19)33762-X 10.1002/hep.1840060603 |
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| DOI | 10.1136/gut.30.10.1396 |
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| Keywords | Human Stomach Azygos vein Liver Pressure gradient Ablation Blood flow Esophagus Cirrhosis Hepatic vein Surgery Blood vessel Digestive diseases Hemodynamics |
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| References_xml | – volume: 112 start-page: 1317 year: 1977 ident: ref_12 article-title: Further evaluation of the Sugiura procedure in the treatment of esophageal varices publication-title: Arch Surg doi: 10.1001/archsurg.1977.01370110051005 contributor: fullname: S, Sugiura M.Futagawa – volume: 1 start-page: 37 year: 1984 ident: ref_3 article-title: Superior portosystemic collateral circulation estimated by azygos blood flow in patients with cirrhosis publication-title: J Heptaol contributor: fullname: A, Cales P.Braillon; D, Jiron I.Lebrec – volume: 66 start-page: 677 year: 1973 ident: ref_6 article-title: A new technique for treating esophageal varices publication-title: J Thlor-ac Cardiovaasc Surg doi: 10.1016/S0022-5223(19)40560-6 contributor: fullname: Sugiura, M.; Futagawa, S. – volume: 4 start-page: 1200 year: 1984 ident: ref_2 article-title: Effects of propranolol on azygos venous blood flow and hepatic and systemic hemodynamics in cirrhosis publication-title: Hepatology doi: 10.1002/hep.1840040617 contributor: fullname: R, Bosch J.I.Mastai; D, Kravetz; J, Bruix J.I.Gaya; J, Rigau; J, Rodes – volume: 52 start-page: 621 year: 1967 ident: ref_5 article-title: S: Rationale for transthoracic esophageal transection for bleeding varices publication-title: Dis Clhest contributor: fullname: Idezuki, Y.; Sugiura, M.; Sakamoto, K.; Abe, H.; Hatano, Miura T.; S, Kimoto – volume: 44 start-page: 181 year: 1971 ident: ref_9 article-title: Measurement of coronary sinus blood flow by continuous thermodilution in man publication-title: Circulation doi: 10.1161/01.CIR.44.2.181 contributor: fullname: W, It) Ganz; K, Tamura; H, Marcus; R, Donoso; S, Yoshida; H, Swan – volume: 10 start-page: 84 year: 1980 ident: ref_7 article-title: Japanese Research Society for Portal Hypertension. The general rules for recording esophageal varices publication-title: Jp)n J Surg – volume: ii: start-page: 1442 year: 1983 ident: ref_14 article-title: Johnson AG: Perforating veins and blood flow in oesophageal variecs publication-title: Lancet contributor: fullname: JD, McCormack T.V.Rose; PM, Smith – volume: 4 start-page: 424 year: 1984 ident: ref_1 article-title: Mcasurcmcnt of azygos venous flow by a continuous thermal dilution tcchniquc publication-title: Hepatology; and Ideuliki an index of blood flow through gastroesophageal collaterals in cirrhosis contributor: fullname: RJ, I.Bosch J.Groszmann – volume: 175 start-page: 466 year: 1972 ident: ref_17 article-title: Ring SM: Significance of an enlarged spienic artery in patients with bleeding varices publication-title: Ann Surg doi: 10.1097/00000658-197204000-00002 contributor: fullname: WM, Dumont A.E.Berman I.R.Stahl – volume: 1979 start-page: 253 issue: 76 ident: ref_11 article-title: Wedged and free hepatic venous pressure measured with a balloon catheter publication-title: Gastroenterologv contributor: fullname: H, Groszmann R.J.Glickman M.Blei A.T.Storer E.Conii – volume: 59 start-page: 208 year: 1970 ident: ref_16 article-title: Splenic blood flow and resistance in patients with cirrhosis before and after portacaval anastomosis publication-title: Gastr-oenteerology doi: 10.1016/S0016-5085(19)33762-X contributor: fullname: HS, Gitlin N.Grahame G.R.Krecl L.Williams; S, Sherlock – volume: 6 start-page: 1244 year: 1986 ident: ref_4 article-title: Effects of metoclopamide and domperidone on azygos venous blood flow in patients with cirrhosis and portal hypertension publication-title: Hepatology doi: 10.1002/hep.1840060603 contributor: fullname: Mastai, R.; Grande, L.; Bosch, J. – volume: 34 start-page: 441 year: 1968 ident: ref_15 article-title: Spienic blood flow in cirrhosis and portal hypertension publication-title: Clin S(i contributor: fullname: HS, Williams R.Condon R.E.Williams; L, Blendis L.M.Kreel – volume: 61 start-page: 169 year: 1967 ident: ref_8 article-title: Gastroesophageal decongestion and splenectomy in the treatment of esophageal varices in Bilharzial cirrhosis: further studies with a report on 355 operations publication-title: Surgery contributor: fullname: Hassab, M.A. – volume: 27 start-page: 3926 year: 1971 ident: ref_10 article-title: A new technique for measurement of cardiac output by thermodilution in man publication-title: Am]JCarliologv contributor: fullname: lGanz W. Denoso R. Marcus H. ForresteriJ Swan H – volume: 1966 start-page: 94 issue: 7 ident: ref_13 article-title: Role of the azygos venous system in the investigation of portal hypertension publication-title: Guit contributor: fullname: Murray, J. – volume: 153 start-page: 295 year: 1987 ident: ref_18 article-title: Idczuki Y: Effects of nonshunting operations on portal venous pressure and hepatic blood flow publication-title: Am J Strg contributor: fullname: K, Kawasaki S.Kidokoro A.Sugiura M.Sanjo |
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| SubjectTerms | Adult Aged Azygos Vein - physiopathology Biological and medical sciences Esophagus - surgery Female Gastroenterology. Liver. Pancreas. Abdomen Humans Liver Cirrhosis - physiopathology Liver Cirrhosis - surgery Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Other diseases. Semiology Postoperative Period Regional Blood Flow |
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| Title | Effects of non-shunting operation on azygos venous blood flow in cirrhotic patients |
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