Ascites Clinical Trial
Official title:
Portal Venous Hemodynamic Changes After Hepatectomy and the Incidence of Postoperative Ascites
The aim of this study is to investigate the pathophysiological mechanisms underlying the formation of posthepatectomy ascites with a focus on the significance of changes in portal venous hemodynamics after hepatic resection. By evaluation of other factors that may be involved in the formation of ascites this study may help to show to what extent the increase of portal venous pressure contributes to ascites formation. Detailed knowledge about pathogenetic factors concerning the formation of postoperative ascites might help preventing protracted hospital stay and further inconveniences to the patient.
The mechanisms underlying the development of large-volume ascites after hepatectomy remain
poorly understood. While studies on animal models suggest an increase of portal venous
pressure after hepatectomy that may in turn favor the transudation of fluid into the
peritoneal cavity further factors may be critically involved in the postoperative formation
of ascites. These factors may include a drop in serum protein levels (and colloid osmotic
pressure), a transient impairment in renal function and a surgery-induced capillary leakage.
However, a better knowledge of the pathophysiology represents the prerequisite for efficient
treatment.
In the present study the impact of changes in hepatic hemodynamics after hepatectomy on
development of ascites will be investigated. Enrolled patients will receive measurement of
portal venous flow and pressure as well as hepatic artery flow before and after hepatic
resection. Associations of changes in these parameters with development of postoperative
ascites and further postoperative complications will be evaluated.
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Observational Model: Cohort, Time Perspective: Prospective
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