Liver function assessed by increased rate of portal venous blood flow after oral intake of glucose

Abstract

Objective: To find out whether an increased rate of portal venous blood flow after oral intake of glucose could be used to estimate liver function. Design: Prospective study. Setting: University hospital, Japan. Subjects: Sixty patients, of whom 23 had hepatocellular carcinoma and liver cirrhosis, 21 had tumours metastatic to normal liver, and 16 had obstructive jaundice treated with percutaneous transhepatic biliary drainage (PTBD). Intervention: Portal flow was measured after oral intake of glucose 75g using pulsed- Doppler ultrasonography. Results: The ratio of portal flow 30 minutes after glucose intake to that before intake (PVFR30) was significantly lower in cirrhotic patients than in those with metastases and a normal liver. A PVFR30 of less than 1.5 indicated impaired hepatic function assessed by the Child-Pugh scores, indocyanine green clearance test, prothrombin time, and hepaplastin test. It also indicated less reduction in total bilirubin concentrations in the first week after PTBD. Conclusions: Results suggest that PVFR30 can be used to estimate liver function and predict outcome after PTBD.