Inter-observer variability of portal hemodynamics measured by Doppler ultrasound on three different locations of portal vein

Tai, Dar‐In; Chuah, Seng Kee; Chen, Chien‐Lin; Lo, Sing Kai; Changchien, Chi‐Sin; Li, Ing Tzu

doi:10.1002/(sici)1097-0096(199602)24:2<61::aid-jcu2>3.0.co;2-i

“…The blood flow calculated for the SMA and the HPV was consistent with values previously reported in the literature and with findings that food ingestion results in increased SMA systolic and diastolic blood flow [12,14,17–19].…”

Section: Discussionsupporting

confidence: 88%

“…Validation of SMA and HPV measurements was achieved by blinded re‐assessment at 0 and at 4392 m. Comparison of data between sonographers showed the intra‐subject coefficient of variation (standard deviation/mean × 100) to be 12% in the SMA and 14% in the HPV. This is similar to that previously reported [12–14].…”

Section: Methodssupporting

confidence: 93%

Do changes in gastro‐intestinal blood flow explain high‐altitude anorexia?

Kalson

¹

,

Hext

²

,

Davies

³

et al. 2010

Eur J Clin Investigation

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“…The flow of the right anterior portal vein and the flow of the hepatic artery were scanned longitudinally, and the flow in those vessels was measured and calculated with the built-in software in all cases to determine the portal venous flow velocity, portal venous flow volume, hepatic arterial flow velocity, and hepatic arterial resistance index. The measuring method and its accuracy were reported in previous studies, [9][10][11][12][13] and we adhered to those fundamental procedures. The measurement time points were as follows: just after specimen removal and in vivo model preparation (control), just after the clamping of the splenic artery, 15 minutes after the clamping of the splenic artery, just after the clamping of the splenic vein, and 15 minutes after the clamping of the splenic vein.…”

Section: Measurement Of Hepatic Flowmentioning

confidence: 94%

“…The flow of the right anterior portal vein and the flow of the hepatic artery were scanned longitudinally, and the flow in those vessels was measured and calculated with the built‐in software in all cases to determine the portal venous flow velocity, portal venous flow volume, hepatic arterial flow velocity, and hepatic arterial resistance index. The measuring method and its accuracy were reported in previous studies, and we adhered to those fundamental procedures.…”

Section: Methodsmentioning

confidence: 99%

Hemodynamic changes in the hepatic circulation after the modulation of the splenic circulation in an in vivo human experimental model

Akamatsu

¹

,

Sugawara

²

,

Satou

³

et al. 2013

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Recent advances in liver surgery have highlighted the effects of the splenic circulation on the hepatic circulation with respect to the hepatic arterial buffer response (HABR). The aim of the present study was to investigate the actual hemodynamic effects of splenic artery embolization/ligation and splenectomy on the hepatic circulation in patients who underwent pancreaticoduodenectomy through in vivo experimental models. In vivo models of splenic artery embolization/ligation (only splenic artery clamping) and splenectomy (simultaneous clamping of both the splenic artery and the splenic vein) were created in 40 patients who underwent pancreaticoduodenectomy for various reasons. The portal venous flow velocity, the portal venous flow volume, the hepatic arterial flow velocity, and the hepatic arterial resistance index were measured with color Doppler ultrasonography. Clamping of the splenic artery induced an immediate and significant increase (16%) in the hepatic artery velocity (P < 0.001), and the portal venous flow also decreased significantly (10%, P 5 0.03). Fifteen minutes after the clamping of the splenic artery, the hepatic artery velocity remained significantly increased at the level of the initial clamping, and the portal venous flow significantly decreased (16%, P < 0.001). Clamping of the splenic vein, which was performed after the clamping of the splenic artery, resulted in an immediate and significant decrease (30%) in the portal venous flow (P < 0.001), but the hepatic arterial flow was not affected. Fifteen minutes after the clamping of the splenic vein, there was no change in the portal flow, which remained significantly lower (28%) than the flow in controls, whereas the hepatic arterial flow further significantly increased (31%, P < 0.001). In conclusion, our findings indicate that both splenic artery embolization/ligation and splenectomy are effective for increasing hepatic arterial flow and decreasing portal flow, with splenectomy providing a greater advantage. The HABR underlies these hemodynamic changes. Liver Transpl 20:116-121, 2014. V C 2013 AASLD.Received June 1, 2013; accepted September 13, 2013.Splenectomy has been performed for patients with liver cirrhosis not only to cure or relieve intractable gastroesophageal varices 1,2 but also to improve liver function before hepatectomy, 3,4 especially in Japan. The technical advances and deeper knowledge gained in the field of liver transplantation have highlighted another role of splenectomy in the regulation of the hepatic circulation via modifications of the splenic circulation. 5,6Abbreviations: HABR, hepatic arterial buffer response; SAS, splenic artery syndrome; SFSS, small-for-size syndrome.

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“…Measurement of portal vein diameter was performed from the hilar segment, which has least interobserver variability. 12 Splenic vein diameter was measured at the splenic hilum.…”

Section: Portal and Splenic Vein Diametersmentioning

confidence: 99%