Hepatic Hemodynamics, Oxygen Supply and Demand before and after Hepatectomy in Cirrhotic Patients

Takafumi Itoh, Toshiaki Nonami, Akio Harada, Tsuyoshi Kurokawa, Tsuyoshi Ujita, Hiroyuki Kobayashi, Motoshi Kainuma*, Yasuhiro Shimada*

Department of Surgery II and Anesthesiology*, Nagoya University School of Medicine

Hepatic hemodynamic changes after hepatectomy were analyzed with an ultrasonic transit time blood flow meter in patients with cirrhosis. Seven patients with cirrhosis had a hyperdynamic systemic circulation and a portal/systemic flow ratio before hepatectomy. Portal resistance increased significantly in cirrhotic patients after hepatectomy. In 7 patients without cirrhosis portal/systemic flow ratio decreased significantly according to increase of cardiac output after hepatectomy. In 10 patients received lobectomy, hepatic oxygen delivery decreased significantly. In conclusion, a hyperdynamic state compensates portal flow in cirrhotic patients whose portal resistanse is high. Since the portal resistance increases after hepatectomy, portal blood flow should be maintained.

Key words
liver cirrhosis, liver resection, hyperdynamic state, portal hemodynamics

Reprint requests
Toshiaki Nonami Department of Surgery, II, Nagoya University School of Medicine
65 Tsuruma-cho, Showa-ku, Nagoya, 466 JAPAN

Accepted
July 7, 1993

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