Published online Mar 15, 2004. doi: 10.3748/wjg.v10.i6.915
Revised: August 23, 2003
Accepted: October 7, 2003
Published online: March 15, 2004
AIM: To evaluate hepatic reserve function by investigating the change of functional hepatic flow and total hepatic flow in cirrhotic patients with portal hypertension.
METHODS: HPLC method was employed for the determination of concentration of D-sorbitol in human plasma and urine. The functional hepatic flow (FHF) and total hepatic flow (THF) were determined by means of modified hepatic clearance of D-sorbitol combined with duplex doppler color sonography in 20 patients with cirrhosis and 10 healthy volunteers.
RESULTS: FHF, evaluated by means of the D-sorbitol clearance, was significantly reduced in patients with cirrhosis in comparison to controls (764.74 ± 167.91 vs 1 195.04 ± 242.97 mL/min, P < 0.01). While THF was significantly increased in patients with cirrhosis in comparison to controls (1 605.23 ± 279.99 vs 1 256.12 ± 198.34 mL/min, P < 0.01). Portal blood flow and hepatic artery flow all were increased in cirrhosis compared to controls (P < 0.05 and P < 0.01). D-sorbitol total clearance was significantly reduced in cirrhosis compared to control (P < 0.01), while D-sorbitol renal clearance was significantly increased in cirrhosis (P < 0.05). In controls FHF was similar to THF (1 195.05 ± 242.97 vs 1 256.12 ± 198.34 mL/min, P = 0.636), while FHF was significantly reduced compared with THF in cirrhosis (764.74 ± 167.91 vs 1 605.23 ± 279.99 mL/min, P < 0.01).
CONCLUSION: Our method that combined modified hepatic clearance of D-sorbitol with duplex doppler color sonography is effective in the measurement of FHF and THF. FHF can be used to estimate hepatic reserve function.