Abstract
We perfomed blocking operations in 205 patients with portal hypertention from September 1979 to March 1983. One hundred and seventy-four cases were transthoracic esophageal transections (Sugiura procedure), 20 were Hassab's operations and 11 were transabdominal esophageal transections. Responses of the blood glucose, serum immunoreactive (IRI) and immunoreactive glucagon dl (IRG) to 100g oral glucose load insulin were studied in 104 patients with cirrhosis and 16 with idiopathic portal hypertention (IPH) before and after Sugiura procedure.
1) Glucose intolerance was recognized in 90 patients with cirrhosis (86%). These 90 cases were divided into two groups (linear type and parabolic type) by the blood glucose response to 100g OGTT (oral glucose tolerance test). The laboratory findings and results of the indocyanin green test (ICGR15, KICG, ICGRmax) were compared between these two groups, but no significant differences were found.
2) Hyperinsulinemia was observed in patients with cirrhosis.
The IRI responses to the 100g OGTT were divided into three groups by the peak value of IRI (high group; IRI≥200μu/ml; medium group; 20%>IRI≥150μu/ml; low group; IRI<150μu/ml). The laboratory findings and ICGR15, KICG, ICGRmax, were also compared among these three groups. Significant differences were observed between the high and low group in total bilirubin (p>0.05), direct bilirubin (p<0.025), Kicc (p<0.05), and ICGR max (p<0.005). The study of the IRI response to the 100g OGTT was useful for the determination of operability in cases of portal hypertension.
3) The IRG response to the 100g OGTT was also studied. But there were no significant relations between IRG values and liver functsions.
4) After the Sugiura procedure, oxyhyperglycemia in the blood glucose response to the 100g OGTT and hypersecretion of IRI were observed.
5) The IRG response to 100g OGTT showed no remarkable change before and after the operation (Sugiura procedure).
