J.Jpn. Surg. Soc.. 62(5): 432-447, 1961
STUDIES ON HEMODYNAMICS IN CHOLELITHIASIS WITH SPECIAL REFERENCE TO HEPATIC CIRCULATION
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Department of Surgery, Nihon Medical School (Director: Prof. Saburo MATSUKURA) Shigetoshi ISHIDA |
1. The quantity of hepatic blood flow in patients with cholelithiasis, though occasionally reduced, is usually within the normal limits. A temporary decrease is noted immediately after operation, but the quantity is restored to normal with the progress of recovery process.
2. In about 20% of patients with cholelithiasis relatively high portal pressure is found, but in the remainder the pressure is normal.
3. The pressure in the hepatic venules of patients with cholelithiasis is in the normal range, even in those showing portal hypertension. This observation dose not agree with the opinion commonly upheld as to the parallelism between the two.
4. In patients with cholelithiasis the portal circulation time is usually normal, there being no cases of either prolongation or shortening.
5. There is no marked difference in the oxygen content of the hepatic artery and vein in patients with cholelithiasis, and the values lie within the normal limits.
6. The oxygen consumption of internal organs is decreased remarkably in about 26% of patients with cholelithiasis. This decrease is further intensified temporarily by operative stress, and gradually returns to normal within 10 days postoperatively.
7. Functional disturbances of the liver are noted to accompany the decreased blood flow of this organ in patients with cholelithiasis, there being a parallel relationship between the two. However, there are 13.3% of cases in which no impairment of liver function occurs in spite of decreased hepatic blood flow, and in the same member of instances with functional disturbances without any decrease in hepatic blood flow. From these findings it is difficult to decide which of these conditions precedes the other.
8. The oxygen consumption rate is decreased in patients with cholelithiasis in accordance with the degree of functional disturbance of the liver. Moreover, the fact that, in spite of decreased blood flow, the decrease in oxygen consumption of organs occurs without exaggerating the difference in the oxygen content of the blood between the hepatic artery and vein suggests the lowered oxygen combining power of the liver.
9. The quantity of cardiac output in patients with cholelithiasis is usually within the normal limits and may show a slight, temporary decrease after operation. It, however, returns to normal with postoperative recovery.
10. Such findings of the blood as circulating blood volume, plasma volume, erythrocyte volume and hematocrit value of patients with cholelithiasis were all within the normal range, there being no remarkable variations in these blood constants.
(Author's abstract)
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