J.Jpn. Surg. Soc.. 82(9): 1055-1058, 1981

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Report on the annual meeting

EVALUATION OF THE HEMODYNAMICS IN THE SELECTION OF PATIENTS FOR SELECTIVE SHUNT

The concept of selective decompression of esophagogastric varices raised some interresting problems. if the gastric wall component are functionally continuous from another component of portal system, then selective decompression is not possible, because portal flow seems to find the way to lower pressure area created by shunt from high pressure area. Is the gastric wall vein system functionally discrete?
In our series of intraoperative manometry of protal system on normal individuals and portal hypertensive patients, it was suggested that the gastric wall vein pressure was closely related to the portal vein pressure with r=0.895 (p＜0.005), Y=0.64X + 157. The difference of the gastric wall vein pressure and portal vein pressure was also related to portal vein pressure with r=－0.748, (p＜0.005). These pressure data indicated that the gastric wall component of the portal system was functionally discrete to pressure levels above than the portal pressure (100-150 mmH₂O) in normals and these pressure barrier between gastric wall veins and portal vein tend to be lower as relations to Y=－0.32X+153 in portal hypertension. The pressure level initiating collateral diversion was thought at the time of pressure barrier O, so selective decompression will be done to persist the barrier pressure normally.

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