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.