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Table of Contents
Vol. 17, No. 4, 2000
Issue release date: 2000
Section title: Original Paper
Dig Surg 2000;17:332–336
(DOI:10.1159/000018874)

Short-Term Hemodynamic Effects of Transjugular Retrograde Obliteration of Gastric Varices with Gastrorenal Shunt

Chikamori F.a · Kuniyoshi N.b · Shibuya S.c · Takase Y.c
Departments of aSurgery, and bInternal Medicine, Kuniyoshi Hospital, Kochi, and cDepartment of Surgery, Tsukuba Soai Hospital, Ibaraki, Japan

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: October 20, 2000
Issue release date: 2000

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU

Abstract

Objectives: The purpose of this study was to investigate the short-term effects on portal hemodynamics of transjugular retrograde obliteration (TJO) of gastric varices with gastrorenal shunt. Methods: Thirty patients with gastric varices and a gastrorenal shunt were included in this study. The patients ranged in age from 42 to 75 years (16 men and 14 women), and according to Child’s classification, class A, B and C cirrhosis was seen in 1, 13 and 16 patients, respectively. The portal blood flow was measured by an ultrasonic duplex Doppler system, and the wedged hepatic venous pressure was measured by hepatic venous catheterization, before and after TJO. Results: Complete obliteration of the gastrorenal shunt and gastric varices was revealed by retrograde inferior phrenic venography and computed tomography after TJO in all cases. The wedged hepatic venous pressure was significantly increased the day after TJO compared with that before therapy (257 ± 71 vs. 307 ± 73 mm H2O, p < 0.01). The portal venous flow was significantly increased 1 week after TJO compared with that before therapy (744 ± 190 vs. 946 ± 166 ml/min, p < 0.01). The serum albumin levels before and after TJO were 3.0 ± 0.4 and 3.1 ± 0.5 g/dl, respectively, and the total bilirubin levels were 1.5 ± 0.7 and 1.5 ± 0.8 mg/dl, respectively, neither of these parameters changing significantly. The plasma ammonia levels before and after TJO were 109 ± 62 and 67 ± 31 μg/dl, and the indocyanine green retention rates at 15 min were 31 ± 13 and 24 ± 13%, both showing a significant change (p < 0.01 and p < 0.05, respectively). Conclusions: We conclude that TJO increases portal blood flow which contributes to the decrease in plasma ammonia levels and the indocyanine green retention rate, although increasing the wedged hepatic venous pressure.

© 2000 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: October 20, 2000
Issue release date: 2000

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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