Impact of Endoscopic Biliary Drainage on Intrinsic Hepatic Blood Flow in Human
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- Category: Vol. 87, December 2019
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Impact of Endoscopic Biliary Drainage on Intrinsic Hepatic Blood Flow in Human, MAHMOUD ALLAM, AHMED ATTIA, ESSAM EL SHIMI, MOHAMED EL WARAKI and WESAM MORAD
Abstract
Background: Obstructive jaundice affects a significant portion of people with injurious effect on the liver. Aim of Study: The study aimed to study the impact of biliary drainage on hepatic blood follow. Patients and Methods: This was a prospective study, conducted from January 2018 to December 2018. Thirty-six patients with biliary obstruction aged 21-72 years, 26 out of them have calcular obstructive jaundice, and the rest of the patients have malignant biliary obstruction. The majority of cases were non-cirrhotic (32 versus 4). Liver tests; (bilirubin level, alkaline phosphatase, GGT, albumin, INR, ALT and AST), and Kidney function tests (blood urea and serum creatinin) and CBC were done. Plus, other pre-ERCP assess-ments were done. Abdominal Ultrasonography (US) and Doppler study of portal and hepatic veins and hepatic artery with measurement of Hepatic artery Resistive Index (RI), Portal vein diameter and congestive index were done, CT and MRCP if indicated and ERCP for all patients. Two weeks after ERCP, all included patients underwent repetition of the same laboratory and Doppler US. Results: Significant changes in patients' laboratories and in liver hemodynamics were noticed after biliary drainage. The mean values of hepatic artery RI were significantly higher and mean values of portal vein maximum velocity (V max) were lower in studied patients before and after biliary drainage. Conclusions: Liver hemodynamics measured by Doppler Ultrasound of hepatic artery RI &V. max of portal vein may be a good predictor of liver injury in biliary obstruction.