Evaluation of portal vascular resistance using an intraoperative Doppler ultrasound.

BACKGROUND/AIMS: To evaluate portal vascular resistance using Doppler ultrasound intraoperatively.

METHODOLOGY

We measured maximum flow velocities and pressures of umbilical portion of the left portal branch before and after clamping of the right main branch of the Glisson's sheath. We proposed a new index, simplified portal resistive index, that was the ratio of the difference of the portal venous pressure to the difference of maximum portal flow velocity.

RESULTS

There were good correlations between portal vascular resistance and simplified portal resistive index. Simplified portal resistive index was found to become higher as fibrotic changes progressed, and there were significant differences between normal liver, chronic hepatitis, and liver cirrhosis.

CONCLUSIONS

Simplified portal resistive index evaluated using intraoperative Doppler ultrasound is an easy and reliable index for assessing portal vascular resistance during liver surgery.