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Prediction of portal pressure from intraoperative ultrasonography


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Title: Prediction of portal pressure from intraoperative ultrasonography
Authors: Nanashima, Atsushi / Abo, Takafumi / Arai, Junichi / Tominaga, Tetsuro / Takagi, Katsunori / Mochinaga, Koji / Furukawa, Katsuro / Nagayasu, Takeshi
Issue Date: Dec-2014
Publisher: Academic Press Inc.
Citation: Journal of Surgical Research, 192(2), pp.395-401; 2014
Abstract: Background Portal hypertension is a major risk factor for hepatic failure or bleeding in patients who have undergone hepatectomy, but it cannot be measured indirectly. We attempted to evaluate the intraoperative ultrasonography parameters that correlate with portal pressure (PP) in patients undergoing hepatectomy. Methods We examined 30 patients in whom PP was directly measured during surgery. The background liver conditions included chronic viral liver disease in seven patients, chemotherapy-associated steatohepatitis in four patients, fatty liver in one patient, hepatolithiasis in one patient, obstructive jaundice in one patient, and a normal liver in 16 patients. A multivariate logistic analysis and linear regression analysis were conducted to develop a predictive formula for PP. Results The mean PP was 10.4 ± 4.1 mm Hg. The PP tended to be increased in patients with chronic viral hepatitis. A univariate analysis identified the association of the six following parameters with PP: the platelet count and the maximum (max), minimum (min), endo-diastolic, peak-systolic, and mean velocity in the portal vein (PV) flow. Using multiple linear regression analysis, the predictive formula using the PV max and min was as follows: Y (estimated PP) = 18.235−0.120 × (PV max.[m/s])−0.364 × (PV min). The calculated PP (10.44 ± 2.61 mm Hg) was nearly the same as the actual PP (10.43 ± 4.07 mm Hg). However, there was no significant relationship between the calculated PP and the intraoperative blood loss and post hepatectomy morbidity. Conclusions This formula, which uses ultrasonographic Doppler flow parameters, appears to be useful for predicting PP.
Keywords: Hepatectomy / Intraoperative ultrasonography / Doppler-portal pressure
URI: http://hdl.handle.net/10069/34989
ISSN: 00224804
DOI: 10.1016/j.jss.2014.05.069
Rights: © 2014 Elsevier Inc. / NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Surgical Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Surgical Research, 192, 2, (2014)
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/34989

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