<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>Systemic and splanchnic hemodynamics were studied before and six months after a portal systemic shunt
(n=6) or a Sugiura procedure (n=9) in 15 patients with cirrhosis and a past history of variceal bleeding.
Hepatic blood flow was estimated by hepatic extraction and clearance of continuous indocyanine green
infusion. Azygos blood flow was measured with a continuous thermodilution catheter. After portocaval
shunt, the cardiac index increased significantly from 4.0±1.4 to 5.4±0.8 l/min m2 (p&lt;0.05), the hepatic venous pressure gradient and hepatic blood flow were significantly decreased from 21±3 to 13±5 mm Hg (p&lt;0.05) and from 1.20±0.35 to 0.37±0.16 l/min (p&lt;0.05) respectively. The decrease in azygos blood flow was not significant (0.51±0.31 vs 0.25±0.33 l/min; p=0.1). After Sugiura procedure, there was no significant change in cardiac index, hepatic venous pressure gradient, hepatic blood flow or azygos blood flow. This is the first study to show the long-term maintenance of splanchnic and systemic hemodynamics
in patients with cirrhosis after Sugiura procedure. The absence of long-term hemodynamic alterations
could explain the absence of encephalopathy after this procedure.</p>
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HPB Surg. 1996; 9(4):209-213