Changes of varicosis and hemodynamics in cirrhotic patients with portal vein hypertension after Hassab devascularization
10.3760/cma.j.issn.1007-5232.2010.10.004
- VernacularTitle:肝硬化门静脉高压症Hassab断流术后患者静脉曲张与血流动力学的变化
- Author:
Yingjian ZHANG
;
Jiansheng LI
;
Ping WANG
;
Jianjun JIN
;
Shuangqin ZHAO
;
Shitong ZHANG
;
Yanli BAI
;
Yufeng ZHENG
- Publication Type:Journal Article
- Keywords:
Hypertension,portal;
Splenectomy;
Esophageal and gastric varices;
Endoscopy
- From:
Chinese Journal of Digestive Endoscopy
2010;27(10):518-521
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the changes of varicosis and hemodynamics in cirrhotic patients with portal vein hypertension at different stages after Hassab devascularization, and to evaluate the outcome.Methods Hassab devascularization was performed in 161 patients with portal vein hypertension, who were all evaluated by means of endoscopy, Doppler color imaging and Child-Pugh grading before and 6, 12, 18,24 months after the procedure, respectively.Results The rates of mild esophageal varicosis were 44.0%,34.8% and 28.3% at 6, 12 and 18 months after Hassab devascularization, respectively, which were all significantly higher than that before the operation(7.5%, P ＜ 0.05), while the rates of severe esophageal varicosis were 25.2%, 29.7% and 34.9% at 6, 12 and 18 months after the procedure, which were significantly lower than that before(65.2%, P ＜ 0.05).The incidence of varices in gastric fundus was correlated with the severity of esophageal varices.At 12 months after the operation, the inner diameters of portal vein and its right branch significantly decreased when compared with those before(P ＜ 0.05), the maximal flow rate,volume of portal vein and average flow rate of the left branch also significantly decreased(P ＜ 0.05).At 6 months after the operation, the average flow rate of the right branch slowed down(P ＜ 0.05).Child-Pugh Grade A accounted for 63.5%, 60.6% and 57.9% at 6, 12 and 18 months after the operation, respectively, which were significantly higher than that before(48.4%, P ＜0.05).When evaluated at 24 months after the procedure, all variables were getting close to those before.Conclusion The severity of esophageal varices mitigates in 18 months after Hassab.Hemodynamics of portal vein system decreases in 12 months.The overall liver function improves in 18 months after the operation.
