J.Jpn. Surg. Soc.. 93(11): 1390-1397, 1992

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Original article

CHANGES IN HEPATIC VOLUME FOLLOWING DIRECT INTERRUPTING SURGERY
FOR PATIENTS WITH ESOPHAGEAL VARICES

The aim of this study is to assess the long term changes in hepatic volume and liver function after direct interrupting surgery. Twenty-four patients with esophageal varices associated with idiopathic portal hypertension（IPH）or liver cirrhosis（LC）who received esophageal transection combined with splenectomy and paraesophago-cardial devascularization were studied, retrospectively. Volume of the liver was obtained by CT scan and was estimated before and after the operation. Plasma indocyanine green disappearance rate（KICG）, body weight and liver function test were also evaluated at the same time. In patients with IPH, liver volume and KICG reduced significantly after direct interrupting surgery（liver volume：－21.3％, p＜0.01, KICG：－25.7％, p＜0.01）. And in patients with LC, liver volume and KICG also significantly reduced after the surgery（liver volume：－9.6％, p＜0.05, KICG：－15.2％, p＜0.05）. However, neither postoperative weight loss nor deterioration of hepatic function was observed. Decreasing rate of the liver volume showed a significant correlation to the spleen volume.
These results suggest that interruption of the splenic blood flow by splenectomy leads to reduction of the effective hepatic blood flow and eventually to decrease in the liver volume.

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