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Feasibility and safety of ultrasound-guided percutaneous transhepatic measurement of portal venous pressure.

Authors :
Yanshan Hu
Shaobo Duan
Ye Zhang
Liuwei Hao
Shuaiyang Wang
Fei Xue
Kewei Zhang
Yadong Zhu
Lianzhong Zhang
Source :
PLoS ONE, Vol 19, Iss 7, p e0305725 (2024)
Publication Year :
2024
Publisher :
Public Library of Science (PLoS), 2024.

Abstract

Background and objectiveThe measurement of portal venous pressure (PVP) has been extensively studied, primarily through indirect methods. However, the potential of ultrasound-guided percutaneous transhepatic PVP measurement as a direct method has been largely unexplored. This study aimed to investigate the accuracy, safety, and feasibility of this approach.MethodsIn vitro, the experiment aimed to select a needle that could accurately transmit pressure, had a small inner diameter and was suitable for liver puncture, and performed on 20 healthy New Zealand white rabbits. An ultrasound-guided percutaneous transhepatic portal vein puncture was undertaken to measure PVP. Additionally, free hepatic venous pressure (FHVP) and wedged hepatic venous pressure (WHVP) were measured under digital subtraction angiography (DSA). The correlation between the two methods was assessed. Enroll study participants from October 18, 2023 to November 11, 2023 with written informed consent. Five patients were measured the PVP under ultrasound guidance before surgery to determine the feasibility of this measurement method.ResultsThere was no significant difference in the results obtained using 9 different types of needles (P > 0.05). This demonstrated a great repeatability (P < 0.05). The 22G chiba needle with small inner diameter, allowing for accurate pressure transmission and suitable for liver puncture, was utilized for percutaneous transhepatic PVP measurement. There were positive correlations between PVP and HVPG (r = 0.881), PVP and WHVP (r = 0.709), HVPG and WHVP (r = 0.729), IVCP and FHVP (r = 0.572). The PVP was accurately and safely measured in 5 patients with segmental hepatectomy. No complications could be identified during postoperative ultrasound.ConclusionPercutaneous transhepatic portal venous puncture under ultrasound guidance is accurate, safe and feasible to measure portal venous pressure.Clinical trial registration numberThis study has been registered in the Chinese Clinical Trial Registry with registration number ChiCTR2300076751.

Subjects

Subjects :
Medicine
Science

Details

Language :
English
ISSN :
19326203
Volume :
19
Issue :
7
Database :
Directory of Open Access Journals
Journal :
PLoS ONE
Publication Type :
Academic Journal
Accession number :
edsdoj.42b22b8df6f547c6a3739c59f22048b7
Document Type :
article
Full Text :
https://doi.org/10.1371/journal.pone.0305725