Previous investigations of authors abroad provided evidence of a reduction of portal pressure by blockers of slow calcium channels group II by verapamil. We decided to investigate the effect of a quite new preparation dilthiazem on the portal haemodynamics in patients with compensated cirrhosis of the liver and oesophageal varices. Doppler examinations of the width, rate of blood flow and flow through the trunk of the portal vein did not prove a statistically significant effect of dilthiazem on the investigated parameters. After the preparation a significant decline of the median pressure in the pulmonary artery was recorded at the 5% level of significance. The significantly elevated pressure values in the wedged position in the hepatic vein (WHVP) as well as of the portohepatic gradient (P-H) rose further after administration of the preparation (WHVP by 12.3%, p P-H by 15%). Even maximum doses of dilthiazem did not influence the portal flow in patients and did not lead to a reduction of the portohepatic gradient. From the results it is apparent that dilthiazem is not suitable for the treatment of portal hypertension.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
TIPS in patients with cranial porta hepatis: ultrasound-guided transhepatic portohepatic-portocaval puncture in single needle pass.
AJR Am J Roentgenol
April 2011
Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1 Rd, Kaohsiung, Taiwan 81346, Republic of China.
Objective: The purpose of this study was to describe our technique of transhepatic serial puncture of the portal vein and hepatic vein-inferior vena cava in one needle pass under ultrasound guidance to place a transjugular intrahepatic portosystemic shunt (TIPS) in patients with a porta hepatis cranial to the usual location.
Materials And Methods: Six patients (five men, one woman) underwent transhepatic TIPS procedures at our institution. The indications for portal decompression were recurrent variceal bleeding in four patients and refractory ascites and hydrothorax in one patient each.
Portal hypertension in primary biliary cirrhosis (PBC): A reversible condition? Yes, but not in all UDCA treated patients.
Hepatol Res
October 2009
Research Centre, Université de Montréal Hospital Centre, Saint-Luc Hospital, Montréal, Québec, Canada.
Portal hypertension is not a rare complication of PBC, but there are no useful clinical predictors of its severity. In fact, in PBC patients, the evaluation of portal hypertension needs a direct access to the portal vein in order to measure the real porto-hepatic gradient (PHG), mainly because of a possible pre-sinusoidal component. The severity of portal hypertension, as measured by the PHG using a thin needle, correlated significantly with the long-term survival of PBC patients, but the initial Mayo score remained the best predictor of survival.
View Article and Find Full Text PDFPortal hypertension and primary biliary cirrhosis: effect of long-term ursodeoxycholic acid treatment.
Gastroenterology
November 2008
Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Hôpital Saint-Luc, Montréal, Québec, Canada.
Background & Aims: Portal hypertension can complicate primary biliary cirrhosis, but studies evaluating the direct measurement of the portohepatic gradient (PHG) are rare. The aim of the study was to determine the prevalence and prognostic value of portal hypertension in patients treated with ursodeoxycholic acid.
Methods: A total of 132 patients from a local "PBC clinic" were enrolled in this cohort study.
Current concepts on the pathophysiology of portal hypertension.
Ann Hepatol
March 2007
Hepatic Hemodynamic Laboratory, Liver Unit. Institut Malalties Digestives I Metabòliques, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Ciber Enfermedades Hepáticas y Digestivas, University of Barcelona, Spain.
Cirrhosis of the liver is by far the most common cause of portal hypertension in the western world. Portal hypertension is a frequent clinical syndrome, defined by a pathological increase in the portal venous pressure. When the portal pressure gradient (the difference between pressures in the portal and the inferior vena cava veins: normal value below 6 mmHg) increases above 10-12 mmHg, complications of portal hypertension can occur.
View Article and Find Full Text PDFTransjugular intrahepatic portosystemic shunt before abdominal surgery in cirrhotic patients: a retrospective, comparative study.
Can J Gastroenterol
June 2006
Liver Unit, Hopital Saint-Luc, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec.
Surgery in cirrhotic patients is associated with high morbidity and mortality related to portal hypertension and liver insufficiency. Therefore, preoperative portal decompression is a logical approach to facilitate abdominal surgery and hopefully to improve postoperative survival. The present study evaluated the clinical outcomes of 18 patients (mean age 58 years) with cirrhosis (seven alcoholics and 11 nonalcoholics) who underwent transjugular intrahepatic portosystemic shunt (TIPS) placement before antrectomy (n=5), colectomy (n=10), small-bowel resection (n=1), pancreatectomy (n=1) and nephrectomy (n=1).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!