PMID: 9173754Jan 1, 1997Paper

Changes in liver perfusion caused by transjugular intrahepatic stent shunt (TIPSS)

Zentralblatt für Chirurgie
G M RichterG W Kauffmann

Abstract

to demonstrate and document TIPSS-induced changes of the perfusion pattern of the liver with special reference to several rheologic, morphologic, functional and biochemical parameters. Our analysis was based on a study in 100 consecutive cases. Evaluation and assessment of the following parameters before and within a 30-day post TIPSS period: portosystemic gradient; morphologic delineation of the portal circulation; invasive scintigraphic determination of the portal perfusion fraction (PPF) and the total liver perfusion (GLP); transcatheter intraarterial flow change measurement; serum levels of albumin and bilirubin; assessment of hepatic encephalopathy by appropriate testing; assessment of recurrent variceal bleeding by TIPSS variceal filling was widely reduced; as assessed morphologically and rheologically portal liver perfusion was significantly reduced. However, there was immediate onset of compensated liver perfusion by increased arterial inflow. Total liver perfusion was not significantly altered. In TIPSS portal decompression was readily achieved with reduction of the portosystemic gradient from an average of 24 mmHg to 10.5 mmHg. In our series we could not demonstrate an increased incidence of hepatic encephalopathy dur...Continue Reading

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