Differential effects on portal and effective hepatic blood flow. A comparison between transjugular intrahepatic portasystemic shunt and small-diameter H-graft portacaval shunt

Annals of Surgery
Alexander S RosemurgyB R Zwiebel

Abstract

This study was undertaken to determine the effects of transjugular intrahepatic portasystemic shunt (TIPS) and small-diameter prosthetic H-graft portacaval shunt (HGPCS) on portal and effective hepatic blood flow. Mortality after TIPS is higher than after HGPCS for bleeding varices. This higher mortality is because of hepatic failure, possibly a result of excessive diminution of hepatic blood flow. Forty patients randomized prospectively to undergo TIPS or HGPCS had effective hepatic blood flow determined 1 day preshunt and 5 days postshunt using low-dose galactose clearance. Portal blood flow was determined using color-flow Doppler ultrasound. Treatment groups were similar in age, gender, and Child's class. Each procedure significantly reduced portal pressures and portasystemic pressure gradients. Portal flow after TIPS increased (21 mL/second +/- 11.9 to 31 mL/second +/- 16.9, p < 0.05), whereas it remained unchanged after HGPCS (26 mL/second +/- 27.7 to 14 mL/second +/- 41.1, p = n.s.). Effective hepatic blood flow was diminished significantly after TIPS (1684 mL/minute +/- 2161 to 676 mL/minute +/- 451, p < 0.05) and was unaffected by HGPCS (1901 mL/ minute +/- 1818 to 1662 mL/minute +/- 1035, p = n.s.). Both TIPS and HGPCS...Continue Reading

References

Jan 1, 1991·American Journal of Surgery·A S RosemurgyR E Kearney
Apr 1, 1990·The Surgical Clinics of North America·E B Rypins, I J Sarfeh
Nov 1, 1986·The Journal of Surgical Research·W J SchirmerD E Fry
Jan 20, 1994·The New England Journal of Medicine·M RössleK Hauenstein
May 1, 1993·American Journal of Surgery·W S HeltonK Johansen

❮ Previous
Next ❯

Citations

Feb 27, 2001·AJR. American Journal of Roentgenology·B E Van BeersY Horsmans
Mar 24, 2010·Microsurgery·Toshiyuki HataEiji Kobayashi
Jun 23, 2001·The American Journal of Gastroenterology·M DelhayeP Galand
Jun 28, 2011·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Yoshihiro NagaoYoshihiko Maehara
Aug 8, 2008·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Toru IkegamiSatoru Imura
Oct 25, 2007·Cardiovascular and Interventional Radiology·Boris RadeleffGoetz M Richter
Jul 25, 2009·World Journal of Gastroenterology : WJG·Mai-Lin ChenJian-Xin Liu
Mar 5, 2013·Scandinavian Journal of Gastroenterology·Muna PalikheMeng Zhang
Oct 5, 2010·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Satoru ImuraEiji Takeda
Feb 11, 2021·Nutrients·Julia TraubVanessa Stadlbauer
Mar 31, 2021·The Cochrane Database of Systematic Reviews·Maria Corina Plaz TorresKurinchi Selvan Gurusamy
Apr 7, 2021·The Cochrane Database of Systematic Reviews·Davide RoccarinaKurinchi Selvan Gurusamy
Apr 11, 2021·The Cochrane Database of Systematic Reviews·Danielle RobertsKurinchi Selvan Gurusamy
Apr 16, 1998·The Journal of Surgical Research·E E ZervosA S Rosemurgy
May 30, 2001·American Journal of Surgery·E E Zervos, A S Rosemurgy
Feb 7, 2001·Gastroenterology Clinics of North America·B E Stabile, M J Stamos

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.