[Experimental and clinical studies on esophago-gastric hemodynamics before and after devascularization for esophageal varices].

Esophago-gastric hemodynamics subsequent to devascularization was studied in a view of changes in mucosal blood flow and tissue oxygen tension (PtO2). Thirty-four mongrel dogs (26 normal dogs and 8 portal hypertensive dogs) were used in experimental studies, and mucosal blood flow was determined by means of hydrogen gas clearance. Remarkable reduction of a 73% in gastric cardia was recognized on normal dogs just after extended devascularization, and those dogs died of severe gastric necrosis within 4 days after surgery. Reduction of a 28.5% in the cardia was found by the devascularization on portal hypertensive dogs produced by a whole liver compression. These portal hypertensive dogs survived for 2 weeks after surgery, and then mucosal blood flows were returned to the previous levels. Liver cirrhosis (10 cases) with esophageal varices were used for clinical studies. Gastric hemodynamics was measured by PtO2 before and after devascularization. Reduction of a 25.7% in the cardia was recognized on cirrhotic patients. These results suggest that influences of extended devascularization on esophago-gastric hemodynamics would be a small in cirrhotic patients with esophageal varices.