Changes in hepatic blood flow after splenectomy and pericardial devascularization

Xiaofei Zhao¹, Zizhao Zhu², Pu He³, Liang Di¹, Guangming Li¹, Daobing Zeng¹*

¹ Department of General Surgery Center, Beijing You’an Hospital, Capital Medical University, Beijing 100069, China  

² Department of General Surgery (First Division), Shenyang Sixth People’s Hospital, Shenyang, China  

³ Department of Thoracoabdominal Surgery, Shijiazhuang Sixth Hospital, Shijiazhuang, China

*Correspondence: Daobing Zeng; Email: dao_zeng@ aliyun.com

Abstract

Objective To analyze hemodynamic changes in the portal vein and hepatic artery after splenectomy and pericardial devascularization.

Methods A total of 132 patients with portal hypertension who underwent splenectomy and pericardial devascularization in Beijing You’an Hospital from June 2014 to June 2017 were selected. Hemodynamic changes in the portal vein, hepatic artery, and hepatic elasticity were recorded before and at 1, 3, 6, 12, 24, and 36 months after the operation, and the characteristics of hepatic blood flow before and after surgery were analyzed.

Results Among the 132 patients, there were 89 men and 43 women aged 27–74 years, with a mean ± standard deviation) age of 48.6 ± 10.6 years. Liver stiffness at 1, 3, 6, 12, 24, and 36 months after surgery was significantly lower than that preoperatively (all P < 0.05). Additionally, portal vein flow and velocity at 1, 3, 6, 12, and 24 months after surgery were significantly lower than those preoperatively (all P < 0.05). Liver stiffness was positively correlated with portal vein flow and velocity. Hepatic artery flow at 1 month after surgery was significantly higher than that preoperatively (P < 0.05).

Conclusion After splenectomy and pericardial devascularization, short-term and long-term liver stiffness, portal venous flow, and portal venous velocity decreased. Liver stiffness was positively correlated with portal venous flow and velocity. Hepatic arterial flow increased only in the short term after surgery.

Keywords: liver cirrhosis, splenectomy, pericardial devascularization, hemodynamics, portal vein flow