Abstract
Portal venous flow (PVF) after oral intake of glucose increases less in patients with liver cirrhosis than in normal volunteers. We investigated whether increases in PVF after oral intake of glucose could be used to estimate liver function.
PVF was measured with Doppler ultrasonography after oral intake of 75g glucose in 60 patients; 23 patients had hepatocellular carcinoma and liver cirrhosis (LC), 21 had tumors metastatic to a normal liver (non-LC), and 16 had obstructive jaundice treated with percutaneous transhepatic cholangio drainage (PTCD) .
The ratio of PVF 30 minutes after glucose intake to that before intake (PVFR30) was significantly lower in LC patients than in non-LC patients. PVFR30 correlated significantly with other indices of liver function, involving Child-Pugh score, prothrombin time, and results of the hepaplastin test, indocyanine green clearance test and galactosyl human serum albumin liver scintigraphy. PVFR30 less than 1.5 indicated impaired hepatic function. Decreased levels of total bilirubin in the 1st week after PTCD were significantly lower in patients in whom PVFR30 was less than 1.5, than in patients in whom PVFR30 was more than 1.5.
These results suggest that PVFR30 can be used to estimate liver function and predict outcome after PTCD.
