Anatomical and functional characteristics of the liver venous system in cholestasis

Clinical and anatomical and functional studies of the liver venous circulation were conducted in 165 patients with chronic hepatitis. Three groups of patients with different manifestations of the activity of the pathological process in the liver were identified: low (65), medium (55) and high (45). Hemodynamic parameters of the liver venous circulation were studied: diameter, cross-sectional area of large veins, maximum and volumetric blood flow velocity, and portal vein pressure indicators. It was revealed that with minimal activity, these indicators increase, but remain within the upper limit of normal, the type of blood supply is eukinetic; with moderate activity of the process, the pressure in the portal vein increases, its diameter expands, the indicators are average between the groups, different types of blood circulation are noted, hyperkinetic and hypokinetic variants appear. With a high degree of activity, the pressure in the portal vein increases significantly, its diameter increases, the linear blood flow velocity decreases, the blood circulation type is hypokinetic. The structural and functional state of the venous system of the liver, circulatory disorders depend on the level of development of cytolytic and cholestatic processes in the liver tissue. The most significant changes are associated with the development of portal hypertension syndrome, while a relationship was observed between the pressure in the portal vein, the diameter of the portal vein and morphological disorders in the liver tissue. The analysis of the conducted research data allows us to draw a conclusion about the stage-by-stage development of pathological disorders in patients with chronic hepatitis, the initial period has a compensatory nature (hyperkinetic blood flow), with the increase of morphological changes, typical signs of decompensation of liver functions appear (hypokinetic blood flow). The results of the study confirm the need to monitor the state of the venous system of the liver and correct the identified disorders in the process of treating patients with chronic hepatitis and cholestasis.