ABSTRACT
Objective To study the changes of liver blood flow with or without portal vein thrombus (PVTT) in hepatocellular carcinoma. Methods The hepatocellular carcinoma patients with PVTT (n=26) and without PVTT (n=35) were enrolled. The diameter and the velocity of hepatic arterial (HA) and portal vein (PV) were measured with color Doppler flow imaging in all patients. Results In the patients with PVTT, the diameter of PV dilated and the velocity of PV dropped significantly and the velocity of HA rised obviously, as compared with those without PVTT. Conclusion The index of HA and PA is very important to guide the therapy of hepatocellular carcinoma.
ABSTRACT
Objective To discuss the technical skills and the contraindication of transjugular intrahepatic portosystemic shunt stent (TIPSS) in portal vein cancercous thrombosis (PVCT) complicated with portal hypertension. Methods There were 16 cases of PVCT with portal hypertension, and average age of 53.6 yr. There were 9 cases with complete occlusion of portal vein trunk and 7 cases with incomplete thrombosis. There were 5 cases with cavernous transformation of the portal vein(CTPV). 1 case of simple upper gastro intestinal tract (GIT) massive bleeding, 4 with refractory ascites and 11 with upper GIT massive bleeding and refractory ascites. Results The procedure of TIPS was successful in 11 cases, the successful rate reached about 68.8%. The mean portal vein pressure was reduced from 4.9kPa to 2.4kPa with average 2.5kPa reduction. Ascites decreased, bleeding stopped and the clinical symptoms disappeared. The average survival period was 136 days. The procedure failed in 5 cases. Conclusions TIPSS is an effective method to control the bleeding and ascites caused by PVCT. The PV cavernous transformation was the contraindication of TIPSS.