Skip to main content
NCBI home page
Gut logoLink to Gut
. 1989 Oct;30(10):1396–1400. doi: 10.1136/gut.30.10.1396

Effects of non-shunting operation on azygos venous blood flow in cirrhotic patients.

N Kokudo 1, S Kawasaki 1, K Ohashi 1, H Sakamoto 1, H Koyama 1, K Sanjo 1, Y Idezuki 1
PMCID: PMC1434407  PMID: 2583566

Abstract

Azygos venous blood flow and other haemodynamic parameters were measured in 14 cirrhotic patients to investigate the effects of a non-shunting operation, oesophageal transection with paraoesophagogastric devascularisation. Azygos venous blood flow measured by the local continuous thermal dilution method was significantly reduced by 13.8% after the operation (428 (41) v 369 (33) ml/min). Hepatic venous pressure gradient (HVPG) was also significantly decreased from 14.5 (0.8) to 12.8 (0.7) mmHg (-11.8%). Cardiac output and routine liver tests did not change remarkably postoperatively. In this haemodynamic study before and after non-shunting operation, moderate but significant decreases were seen in azygos venous blood flow and portal pressure (HVPG), without substantial changes in systemic circulation. This suggests that blood flow through the portosystemic collaterals other than oesophageal varices may be decreased but still adequate after the operation. Well preserved portosystemic collaterals without oesophageal varices are thus considered an optimally balanced state after non-shunting operation.

Full text

PDF
1396

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bosch J., Groszmann R. J. Measurement of azygos venous blood flow by a continuous thermal dilution technique: an index of blood flow through gastroesophageal collaterals in cirrhosis. Hepatology. 1984 May-Jun;4(3):424–429. doi: 10.1002/hep.1840040312. [DOI] [PubMed] [Google Scholar]
  2. Bosch J., Masti R., Kravetz D., Bruix J., Gaya J., Rigau J., Rodes J. Effects of propranolol on azygos venous blood flow and hepatic and systemic hemodynamics in cirrhosis. Hepatology. 1984 Nov-Dec;4(6):1200–1205. doi: 10.1002/hep.1840040617. [DOI] [PubMed] [Google Scholar]
  3. Calès P., Braillon A., Jirón M. I., Lebrec D. Superior portosystemic collateral circulation estimated by azygos blood flow in patients with cirrhosis. Lack of correlation with oesophageal varices and gastrointestinal bleeding. Effect of propranolol. J Hepatol. 1985;1(1):37–46. doi: 10.1016/s0168-8278(85)80066-0. [DOI] [PubMed] [Google Scholar]
  4. Dumont A. E., Berman I. R., Stahl W. M., Ring S. M. Significance of an enlarged splenic artery in patients with bleeding varices. Ann Surg. 1972 Apr;175(4):466–471. doi: 10.1097/00000658-197204000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ganz W., Donoso R., Marcus H. S., Forrester J. S., Swan H. J. A new technique for measurement of cardiac output by thermodilution in man. Am J Cardiol. 1971 Apr;27(4):392–396. doi: 10.1016/0002-9149(71)90436-x. [DOI] [PubMed] [Google Scholar]
  6. Ganz W., Tamura K., Marcus H. S., Donoso R., Yoshida S., Swan H. J. Measurement of coronary sinus blood flow by continuous thermodilution in man. Circulation. 1971 Aug;44(2):181–195. doi: 10.1161/01.cir.44.2.181. [DOI] [PubMed] [Google Scholar]
  7. Gitlin N., Grahame G. R., Kreel L., Williams H. S., Sherlock S. Splenic blood flow and resistance in patients with cirrhosis before and after portacaval anastomoses. Gastroenterology. 1970 Aug;59(2):208–213. [PubMed] [Google Scholar]
  8. Hassab M. A. Gastroesophageal decongestion and splenectomy in the treatment of esophageal varices in bilharzial cirrhosis: further studies with a report on 355 operations. Surgery. 1967 Feb;61(2):169–176. [PubMed] [Google Scholar]
  9. Idezuki Y., Sugiura M., Sakamoto K., Abe H., Miura T., Hatano S., Kimoto S. Rationale for transthoracic esophageal transection for bleeding varices. Dis Chest. 1967 Nov;52(5):621–631. doi: 10.1378/chest.52.5.621. [DOI] [PubMed] [Google Scholar]
  10. Mastai R., Grande L., Bosch J., Bruix J., Rigau J., Kravetz D., Navasa M., Pera C., Rodés J. Effects of metoclopramide and domperidone on azygos venous blood flow in patients with cirrhosis and portal hypertension. Hepatology. 1986 Nov-Dec;6(6):1244–1247. doi: 10.1002/hep.1840060603. [DOI] [PubMed] [Google Scholar]
  11. McCormack T. T., Rose J. D., Smith P. M., Johnson A. G. Perforating veins and blood flow in oesophageal varices. Lancet. 1983 Dec 24;2(8365-66):1442–1444. doi: 10.1016/s0140-6736(83)90796-1. [DOI] [PubMed] [Google Scholar]
  12. Sugiura M., Futagawa S. A new technique for treating esophageal varices. J Thorac Cardiovasc Surg. 1973 Nov;66(5):677–685. [PubMed] [Google Scholar]
  13. Sugiura M., Futagawa S. Further evaluation of the Sugiura procedure in the treatment of esophageal varices. Arch Surg. 1977 Nov;112(11):1317–1321. doi: 10.1001/archsurg.1977.01370110051005. [DOI] [PubMed] [Google Scholar]
  14. Williams R., Condon R. E., Williams H. S., Blendis L. M., Kreel L. Splenic blood flow in cirrhosis and portal hypertension. Clin Sci. 1968 Jun;34(3):441–452. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES