Name of the Procedure:

Hepatic Venography, Wedged or Free, Without Hemodynamic Evaluation, Radiological Supervision and Interpretation

Summary

Hepatic venography is a radiological procedure used to visualize the veins in the liver. This procedure helps healthcare providers diagnose and manage liver-related conditions by depicting the venous anatomy of the liver. It is done without measuring blood flow parameters (hemodynamics).

Purpose

The procedure aims to diagnose liver diseases, particularly those affecting the blood vessels within the liver. By creating a detailed image of the liver’s venous system, medical professionals can identify blockages, abnormal blood flow, or other vascular issues.

Indications

• Suspected liver cirrhosis
• Portal hypertension
• Liver tumors or metastases
• Unexplained liver dysfunction
• Preoperative planning for liver surgery or transplantation

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Medications may be adjusted, particularly blood thinners.
• Blood tests and imaging studies may be performed beforehand to assess liver function and anatomy.

Procedure Description

1. The patient lies on an x-ray table.
2. A local anesthetic is administered to numb the area where the catheter will be inserted, usually in the groin or neck.
3. Using x-ray guidance, a catheter is inserted into the hepatic vein.
4. Contrast dye is injected through the catheter to make the veins visible on x-ray images.
5. Wedged or free hepatic venography involves obtaining images with the catheter tip positioned either at a wedged (branch) or free (main vein) position within the liver.

Duration

The procedure typically lasts 30 minutes to 1 hour.

Setting

Hepatic venography is performed in a hospital's radiology or interventional radiology department.

Personnel

• Interventional radiologist
• Radiologic technologist
• Nursing staff for assistance and patient care

Risks and Complications

• Infection at the catheter insertion site
• Bleeding or bruising
• Allergic reaction to contrast dye
• Blood vessel damage or thrombosis
• Rare complications include liver injury or significant bleeding.

Benefits

• Accurate diagnosis of liver vascular conditions
• Planning for effective treatment strategies
• The benefits are usually realized immediately after results are analyzed.

Recovery

• Patients are monitored for a few hours post-procedure.
• Instructions may include rest, avoiding strenuous activities, and hydration.
• Follow-up appointments may be necessary to discuss results and further treatment.

Alternatives

• Non-invasive imaging studies like Doppler ultrasound, CT angiography, or MRI
• Each alternative has pros and cons: for example, Doppler ultrasound is less invasive but may not be as detailed as hepatic venography.

Patient Experience

• Patients may feel pressure or minor discomfort during catheter insertion.
• Post-procedure, some soreness at the insertion site is common.
• Pain management with over-the-counter pain relievers and comfort measures will be provided as needed.