Comparative Study of Portal Hemodynamics and Regional Hepatic Blood Flow before and after Hepatic Resection by ¹³³Xe-scintiphotosplenoportography

Tadashi Yasuda, Yo Sasaki, Shingi Imaoka, Takashi Shibata, Hisashi Wada, Hiroaki Nagano, Takeshi Iwanaga, Shunichi Nakano¹⁾, Yoshihisa Hasegawa¹⁾

Department of Surgery, The Center for Adult Diseases, Osaka
Department of Nuclear Medicine¹⁾

Changes in the portal circulatory pattern and regional hepatic blood flow (rHBF) after surgical liver resection were studied by ¹³³Xe-scintiphotosplenoportography (SSP). The visual patterns of pre- and postoperative portal circulation were compared. Different patterns were observed after the operation in five of 27 patients (portosystemic shunt formation 3, progression 1, regression 1). The patients with porto-systemic shunt showed postopertive complications (massive ascites, jaundice, cardiopulmonary failure) more frequently than those without it. The ratio of rHBF increase (post-/pre-operative rHBF) was 1.36±0.63 on average. The ratio was higher in patients with good liver function or without liver cirrhosis. The ratio also correlated with the weight of the liver resected. But operation time, blood loss or whether hepatic bloodsupply was clamped off during the operation did not affect the ratio. Resection in the right lobe, however, caused a greater rHBF increase in the residual liver than the same degree of resection in the left lobe. SSP could be a useful method for investigating the effect of hepatic resection on portal hemodynamics and it is suggested that existence of portosystemic shunt influences the postoperative course.

Key words
scintiphotosplenoportography, portal hemodynamic change after hepatic resection, regional hepatic blood flow

Reprint requests
Tadashi Yasuda 2nd Department of Surgery, Osaka University School of Medicine
1-1-50 Fukushima, Fukushima-ku, Osaka, 553 JAPAN

Accepted
February 14, 1990

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