Hemodynamic Modulations to Ameliorate Sinusoidal Injuries After Extended Liver Resections: the Role of Splenic Artery Ligation and Porto-caval Shunt in a Series of Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Small-For-Size Liver Syndrome
- Sponsor
- Aretaieion University Hospital
- Enrollment
- 13
- Locations
- 1
- Primary Endpoint
- portal vein flow
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
Our study aimed at assessing the changes of portal vein pressure, portal vein flow and hepatic arterial flow (HAF) in liver remnants ≤ 30% of the standard liver volume by reducing portal vein overflow via ligation of the splenic artery.
Detailed Description
It has been reported that prevention of acute portal overpressure in small-for-size liver grafts leads to better postoperative outcomes. Accordingly, we aimed to investigate the feasibility of the technique of splenic artery ligation in a case series of patients subjected to major liver resections with evidence of small-for-size syndrome and whether the maneuver results in reduction of portal venous pressure and flow.
Investigators
Dr Kassiani Theodoraki
Professor of Anesthesiology
Aretaieion University Hospital
Eligibility Criteria
Inclusion Criteria
- •Adult patients
- •American Society of Anesthesiologists (ASA) distribution I to III
- •Patients scheduled for major liver resection (≥4 segments)
Exclusion Criteria
- •patients with extrahepatic disease
- •patients with metastatic liver tumors
Outcomes
Primary Outcomes
portal vein flow
Time Frame: through the operation, an average period of two hours
change of portal vein flow from before liver resection to after reperfusion of the liver remnant
hepatic artery flow
Time Frame: through the operation, an average period of two hours
change of hepatic artery flow from before liver resection to after reperfusion of the liver remnant
portal vein pressure
Time Frame: through the operation, an average period of two hours
change of portal vein pressure from before liver resection to after reperfusion of the liver remnant