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

作者：Yanshan Hu, Shaobo Duan, Ye Zhang, Liuwei Hao, Shuaiyang Wang, Fei Xue, Kewei Zhang, Yadong Zhu, Lianzhong Zhang · 发表于：PLoS ONE · 年份：2024 · DOI：10.1371/journal.pone.0305725 · 研究领域：Liver Disease and Transplantation、Hepatocellular Carcinoma Treatment and Prognosis、Hemodynamic Monitoring and Therapy

BACKGROUND AND OBJECTIVE: The 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. METHODS: In 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. RESULTS: There 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 correlat...