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英文誌(2004-)

Journal of Medical Ultrasonics

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1985 - Vol.12

Vol.12 No.05

Case Report(症例報告)

(0421 - 0427)

門脈外科におけるドップラ断層の術中応用

Clinical Experiences of Intra-operative Real-time Two-dimensional Echography in the Surgery of Portal Vein or Its Branches

鋤柄 稔1, 高本 真一1, 駒崎 敏郎1, 山崎 達雄1, 古賀 和美1, 松村 誠1, 馬木 清隆2, 尾本 良三1

Minoru SUKIGARA1, Shinichi TAKAMOTO1, Toshiro KOMAZAKI1, Tatsuo YAMAZAKI1, Kazumi KOGA1, Makoto MATSUMURA1, Kiyotaka UMAKI2, Ryozo OMOTO1

1埼玉医科大学第一外科, 2アロカ株式会社

1First Department of Surgery, Saitama Medical School, 2Aloka Co.

キーワード : Doppler ultrasound, Portal hypertension, Intraoperative, Distal spleno-renal shunt

 We have used real-time two-dimensional Doppler echography (2-D Doppler) during the surgery of portal vein or its branches in four cases. Distal spleno-renal shunt (DSRS) was performed in two cases, whereas the left gastric venous-caval shunt (LGCS) and the partial resection of portal vein was performed in each one case, respectively. 2-D Doppler system is Aloka SSD 880 (Frequency: 3.5 MHz) and newly developed Aloka XA 340 (Frequency: 5.0 MHz).
 In all cases vivid color flow images of the vessels, including the flow which passed through the anastomosis, were obtained clearly by either machine. During the decompression surgery, i.e. in DSRS and LGCS, we were able to detect the hemodynamic changes quantitatively by measuring the flow velocity of the portal vein, the splenic vein, the left renal vein and the inferior vena cava. Ample blood flow was ascertained after the resection of the portal vein and its re-anastomosis.
 Intra-operative use of 2-D Doppler is effective for evaluating the hemodynamic changes during the surgery of the portal vein or its branches.