Changes in liver function parameters after occlusion of gastrorenal shunts with balloon-occluded retrograde transvenous obliteration
Akahane, T.; Iwasaki, T.; Kobayashi, N.; Tanabe, N.; Takahashi, N.; Gama, H.; Ishii, M.; Toyota, T.
American Journal of Gastroenterology 92(6): 1026-1030
1997
ISSN/ISBN: 0002-9270 PMID: 9177524 Document Number: 480367
Objective and Methods: To evaluate the effects of portal blood flow on liver function, this pilot study investigated the correlation between changes in portal blood flow as measured by image-directed Doppler ultrasonography and liver function tests in nine patients with cirrhosis who were treated with balloon-occluded retrograde transvenous obliteration. All patients had large gastric varices and prominent gastrorenal shunts. Results: Treatment caused a significant increase (p lt 0.01) in portal blood flow; we documented reversion from hepatofugal to hepatopetal portal flow in one patient and increases in hepatopetal flow from 5.4 +- 1.1 to 7.85 +- 1.4 cm/s (mean +- SD) in eight patients. All patients showed decreases in gastric variceal size. However, portal pressure rose significantly in all patients after treatment from 25.4 +- 7.6 to 30.7 +- 5.8 mmH-2O (n = 7, mean +- SD), and two of nine patients had worsening of esophageal varices. All nine patients showed improvement in the 15-min retention rate of indocyanine green from 31.8 +- 16.1 to 21.8 +- 12.4% (mean +- SD, p lt 0.01), whereas seven patients showed increased serum albumin levels after treatment. Conclusions: These results suggest balloon-occluded retrograde transvenous obliteration increases hepatic portal blood flow, which may be accompanied by improvements in liver function.