Post-prandial portal hemodynamics after upper gastrointestinal tract abscission.

Background/aims: The purpose of this study is to analyze the changes in post-prandial portal hemodynamics after upper gastrointestinal tract abscission, using pulsed Doppler ultrasonography.

Methodology: The study group consisted of normal volunteers and patients who had undergone total gastrectomy (TG), distal partial gastrectomy (PG), transthoracic esophagectomy and reconstruction with a gastric tube (TE), pancreatoduodenectomy (PD), or pylorus-preserving pancreatoduodenectomy (PPPD). The maximal portal blood flow velocity (Vmax) was measured by the pulsed Doppler method before and after nutrient intake. Ratio of each postprandial mean Vmax to pre-prandial mean Vmax was described as ratio of flow velocity (RFV).

Results: In the TG group, the RFV curve shifted markedly to the left in comparison to that in the control and PG groups. The pattern in the TE group was similar to that in the control group. In the PD group, the curve shifted to the left in comparison to that in the control group. In the PPPD group, the RFV was low throughout the examination. The pattern in the PPPD Billroth-I reconstruction group was similar to that in the control group, but not to the PPPD Billroth-II reconstruction group.

Conclusions: The pattern of RFV reflectedfood transport dynamics after upper gastrointestinal surgery.