Background/aims: The clinical significance of the hepatofugal portal blood flow after abdominal surgery involving other than portosystemic shunt was investigated in our hepatobiliary pancreatic surgical division.
Methodology: Preoperative and postoperative Color and pulsed Doppler ultrasonography was performed on 101 consecutive patients who underwent abdominal surgery. Preoperative Doppler ultrasonography was performed within one week before surgery. Basically, postoperative Doppler ultrasonography was performed every other day within one week after surgery and once a week 2 weeks after surgery. The portal flow direction was assessed in the right portal branch or the umbilical portion of the left portal branch.
Results: Of the 101 patients, 9 showed a hepatofugal flow in the intrahepatic portal vein, 5 of which showed a total hepatofugal flow, and 4 of these 5 patients died of hepatic failure. The remaining 4 patients showed a partial hepatofugal flow and postoperative hyperbilirubinemia, but all 4 survived.
Conclusions: Postoperative total hepatofugal flow indicated a serious prognostic sign of critical liver damage. Postoperative partial hepatofugal flow induced postoperative hyperbilirubinemia which was not critical.