Evaluation of the Intraoperative Hemodynamics in Abdominal Visceral Organs of Portal System with the Use of Laser Doppler Flowmeter

Yoshio Arai, Kenji Koyama, Yoshihiro Asanuma, Susumu Omokawa, Shugo Kashima, Teiji Takahashi, Kimiyuki Shirayama, Setsuro Yoshida, Yasuaki Takemasa, Tomoki Furuya, Tsutomu Sato

lst Department of Surgery, Akita University School of Medicine

The objective of this study was to evaluate the effect of surgery on the abdominal visceral organs. The tissue blood flow in the liver, stomach and small intestine were measured with a Laser Doppler flowmeter during surgery. In addition, the correlation between changes in the tissue blood flow and post operative liver dysfunction was assessed. Subjects were divided into 5 groups according to the operative procedure and the disease; namely subtotal gastrectomy for the gastric cancer group, and total gastrectomy for the gastric cancer group, the benign biliary tract disease group, the malignant biliary tract disease group and the miscellaneous group. The tissue blood flow of the liver at the end of the operation was significantly decreased to 69.0% for the total gastrectomy group and 56.7% for the malignant biliary tract disease group, while that for the other three groups did not show notable changes in the hepatic blood flow. However, the tissue blood flow of the small intestine which can represent the portal venous flow was maintained during the operation for each group. The results suggest that the portal venous flow is maintained during surgery and that the decrease in the hepatic arterial flow is one of the causes of the decrease in hepatic tissue blood flow. GOT worsened after the operation for the malignant group, and part of the benign biliary tract disease group, indicating that manipulation of the liver during surgery strongly affects liver function.

Key words
laser doppler flow meter, tissue blood flow, surgical trauma, glutamate oxaloacetate transaminase

Reprint requests
Yoshio Arai lst Department of Surgery, Akita University School of Medicine
1-1-1 Hondo, Akita, 010 JAPAN

Accepted
October 11, 1989

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