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Portal Venous Hemodynamic Changes After Hepatectomy

H

Heidelberg University

Status

Unknown

Conditions

Hepatectomy
Ascites

Treatments

Procedure: Portal venous flow
Procedure: Portal venous pressure
Procedure: Hepatic artery flow

Study type

Observational

Funder types

Other

Identifiers

Details and patient eligibility

About

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.

Full description

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.

Enrollment

110 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Patients scheduled for elective hepatic resection
  • Age equal or greater than 18 years
  • Informed consent

Exclusion criteria

  • Evidence of ascites or hypalbuminemia preoperatively
  • Renal insufficiency
  • Expected lack of compliance
  • Impaired mental state or language problems

Trial design

110 participants in 3 patient groups

Major hepatic resection
Description:
Patients undergoing resection of \> 2 liver segments
Treatment:
Procedure: Portal venous pressure
Procedure: Portal venous flow
Procedure: Hepatic artery flow
Minor hepatic resection
Description:
Patients undergoing resection of \</= 2 liver segments
Treatment:
Procedure: Portal venous pressure
Procedure: Portal venous flow
Procedure: Hepatic artery flow
Control group
Description:
Patients undergoing exploratory laparotomy for hepatobiliary disease without resection (e.g. due to inoperable disease)
Treatment:
Procedure: Portal venous pressure
Procedure: Portal venous flow
Procedure: Hepatic artery flow

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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