Observation On The Effects Of Liver Tumor Resection On Portal Venous Flow

Partial resection of the liver is the most thorough treatment of benign and malignant liver effective way, with the perioperative management of surgical techniques to enhance and improve the liver, liver resection and removal of the scope of expanding the indication, many in the past that can not removed huge hepatic neoplasms is now successfully removed. With the progress in liver surgery, postoperative complications, a variety of complex, also begun to attract increasing attention. In the past that the extensive occurrence of liver failure after hepatectomy the main reason is because too much liver resection, the remaining less than the number of liver cells, liver metabolism disorder. Recent studies show that after the primary mechanism of liver injury and liver resection of acute portal vein hypertension. The main portal vein for the pathogenesis of excessive portal perfusion pressure and blood flow also increased, leading to high portal pressure sinusoidal endothelial damage, thus making liver cells degeneration and necrosis and sub-large, and even acute liver failure [1].That when liver resection of more than a certain range, the portal vein pressure can be increased; after high portal pressure often leads to the remaining liver reperfusion injury, and is regarded as liver failure after resection of liver tumors mainly occurred. Based on the above understanding, we envisage a wide range of liver tumor in the liver resection, the supply of blood flow to the liver volume has been reduced in the liver, sinusoidal vascular bed area decreased, it can predict may occur after acute hypertension, The high pressure of portal vein remnant liver cells may be a direct injury, causing or promoting the occurrence of liver failure, which is the main reason for postoperative mortality [2]. Portal pressure by reducing portal vein can significantly reduce the over-perfusion of the liver damage, thus improving liver surgery to reduce the liver damage.The aim of this sum up to 1 year in our hospital clinical data of liver resection, liver resection of portal hemodynamics after the change of the role of liver damage; and lower portal pressure of liver resection on liver injury effect. Methods:The subjects of Jinan Military General Hospital in July 2008～July 2009 hospitalization and surgical resection of liver tumors by clinical data.Summarizes the portal vein pressure change factor. Observation of the liver after partial hepatectomy in patients with portal venous pressure (FPP) changes before and after surgery using color Doppler ultrasound in portal hemodynamics in patients tested, respectively,3 days before surgery, after 1,3,7 days, taking blood samples of liver function were measured.Designed randomized controlled studies, randomized into treatment group (A) and control group (B). The basis of the first measurement of portal pressure, when measured again after removal of foci foci resection of portal vein pressure after intravenous infusion of somatostatin or normal saline 2h,6h,12h and then measure portal vein pressure medication. After 1,3,7 days, blood samples were collected liver function parameters were measured. Treatment group (A) after intravenous infusion of somatostatin began. The control group (B) saline, in addition to other therapeutic measures with the A group.All the patients suffered from liver resection FPP a transient rise to a wide range of liver cirrhosis with resection increased the most significant. FPP is increased rate of liver resection, the duration of portal occlusion, liver cirrhosis is closely linked. Hepatic function and portal vein pressure is closely related to, the greater the pressure difference between the portal vein, postoperative liver function worse.Somatostatin remnant liver in patients with portal venous pressure continued to decline with somatostatin in patients without residual hepatic portal venous pressure was maintained at the original high pressure state.1st day after the study group and control group, liver function showed different degrees. The 7th day, liver function indexes in control group are significantly better, then the corresponding target somatostatin group had returned to normal.(1) partial hepatectomy increased the level of portal vein pressure, and the size of liver resection, liver cirrhosis, liver function (Child-Pugh) classification hepatic inflow occlusion is closely related to the length of time.(2) portal blood flow velocity in the prevalence of liver resection, vascular ultrasound showed widened portal vein, reduced blood flow, blood flow slows down. The greater amount of liver resection, the more significant this phenom-enon, the consequences are more serious(3) changes in portal pressure of liver function after different degrees of impact,the greater the pressure difference between the portal vein,postoperative liver function worse.Tips to take the necessary measures to reduce postoperative portal venous pressure on liver function recovery benefit.(4) Liver cirrhosis and portal hypertension in liver cancer patients with postoperative residual liver somatostatin help improve liver function, promote damage to the residual liver function recovered rapidly.