Nagasue N, Yukaya H, Ogawa Y, Higashi T
Ann Chir Gynaecol. 1983;72(1):18-22.
In 24 patients with and without cirrhosis of the liver, portal vein pressure was measured prior to and after hepatic resections of various magnitudes. In 6 patients who underwent resection of less than 20% of the liver portal pressure did not change although all patients had associated cirrhosis. On the other hand, a substantial rise in portal pressure was found in 17 of 18 patients who had resection of more than 30% of the liver irrespective of the presence or absence of cirrhosis. No significant difference was observed between the degree of portal pressure rise and the magnitude of hepatic resection. Also, there was no difference in the increase in portal pressure between the patients with and without cirrhosis of the liver. The present study may indicate that splanchnic sequestration associated with acute portal hypertension frequently occurs even in humans after resection of 30% or more of the liver even if the remaining liver is normal and anatomical dissection has been employed. Appropriate intra- and postoperative management is necessary to combat this difficult condition.
在24例有或无肝硬化的患者中，于各种程度的肝切除术前和术后测量门静脉压力。6例接受肝切除量少于20%的患者，尽管所有患者均伴有肝硬化，但门静脉压力未发生变化。另一方面，18例肝切除量超过30%的患者中有17例出现门静脉压力显著升高，无论有无肝硬化。门静脉压力升高程度与肝切除量之间未观察到显著差异。此外，有肝硬化和无肝硬化的患者之间门静脉压力升高情况也无差异。本研究可能表明，即使剩余肝脏正常且采用了解剖性分离，在人类肝切除量达到30%或更多后，常发生与急性门静脉高压相关的内脏血液淤滞。对抗这种困难情况需要适当的术中和术后管理。
