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Studies on hepatic resectability and the interruption of hepatic blood inflow in dogs with obstructive jaundice

Research Project

Project/Area Number 01480324
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field Digestive surgery
Research InstitutionMie University

Principal Investigator

MIZUMOTO Ryuji  Mie University, Faculty of Medicine, Professor, 医学部, 教授 (00025561)

Co-Investigator(Kenkyū-buntansha) YOKOI Hajime  Mie University, Faculty of Medicine, University Hospital, Lecturer, 医学部附属病院, 講師 (60174843)
NOGUCHI Takashi  Mie University, Faculty of Medicine, Associate Professor, 医学部, 助教授 (40144258)
KAWARADA Yoshifumi  Mie University, College of Medical Sciences, ProFessor, 医療技術短期大学部, 教授 (40024814)
Project Period (FY) 1989 – 1991
Project Status Completed (Fiscal Year 1991)
Budget Amount *help
¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 1991: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1990: ¥700,000 (Direct Cost: ¥700,000)
Keywordsfunctional resectabity of the liver / function of sinusoidal lining cell of the liver / hepatic artery interruption / major hepatic necrosis / portal stasis / ischemia-reperfusion injury / free radical / free radical scavenger / 黄疸遷延 / 肝予備力低下 / 肝微細構造 / sinusoidal block / 肝切除限界 / 一期的肝切除 / 肝細胞糸粒体 / kupffer細胞
Research Abstract

Obstructive jaundice was produced in adult mongrel dogs by cholecystectomy and ligation-cut off of the di!ktal common bile duct, and the resectability and the tolerable limit of interruption of hepatic blood inflow in the liver with obstructive jaundice were functionally and morphologically evaluated.
(1) Resectability of the liver with obstructive jaundice : When hepatectomy was performed with choledochoduodenostomy 2 weeks after production of obstructive jaundice, the 4-week survival rate was : 71% after 40% hepatectomy and 22% after 70% hepatectomy, respectively. The IGGRmax value before hepatectomy clearly indicated the limit of one-staged hepatectomy. On the other hand, when the choledochoduodenostomy for reduction of jaundice prior to hepatectomy was performed 3 weeks after production of obstructive jaundice, followed by 70% hepatectomy, many dogs that received hepatectomy 2 weeks after choledochoduodenostomy died within 4 weeks after two-staged hepatectomy, because of the insuffi … More cient of the reticuloendothelial' system and the coagulation-fibrinolysis system even if the hepatic reserve had been restored above the critical level. The 4-week survival rate. in dogs that underwent hepatectomy 3 weeks after the choledochoduodenostomy was significantly better at 67%.
(2) Tolerable limit of interruption of the hepatic blood inflow : When the blood supply of the liver was interrupted simultaneously with choledochoduodenostomy 2 or 3 weeks after production of obstructive jaundice, the tolerable limits of interruption 2 and 3 weeks after production of, jaundice were 2 hours and I hour, respectively, in the hepatic artery, 20 and 10 minutes in the portal vein, and 10 and 5 minutes in both the hepatic artery and portal vein. The tolerable limit of interruption shortened as the duration of jaundice was longer. Especially, in the dogs that received interruption of the hepatic artery, the cause of death was extensive neurosis of the liver, and the choledochoduodenostomy was not effective even if those that survived, with electron microscopy suggesting significant prolongation of jaundice as compared with the dogs that received the choledochoduodenostomy alone.
(3) Hepatic resectability after interruption of the hepatic blood inflow and reperfusion : In dogs that received 40% hepatectomy and the choledochoduodenostomy after 5- or 10-minute simultaneous interruption of the hepatic artery and the portal vein followed by 60-minute reperfusion 2 or 3 weeks after production of obstructive jaundice, the 1-week survival rate was significantly lower than in those that received the choledochoduodenostomy alone (40% and 20% 2 and 3 weeks, respectively, after production of jaundice). In the former group, lipid peroxides levels of the liver tissue and blood of were increased at both times, respectively. However, the survival rate improved, and the liver injury was milder, when a free radical scavenger such us Coenzyme Q_<10>, Superoxide dismutase and so on was administered before interruption of the hepatic blood inflow. Less

Report

(4 results)
  • 1991 Annual Research Report   Final Research Report Summary
  • 1990 Annual Research Report
  • 1989 Annual Research Report
  • Research Products

    (40 results)

All Other

All Publications (40 results)

  • [Publications] Ryuji Mizumoto: "Surgical anatomy of the hapatic hilum with special reference to the caudate lobe" World J.Surg.12. 2-10 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 水本 龍二: "臨床医学の展望ー肝、胆道、膵外科" 日本医事新報. 3380. 15-21 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 水本 龍二: "胆道癌の治療ー現況と対策" 胆道. 3. 373-377 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 水本 龍二: "肝臓外科における手術危険度と手術適応の拡大" 日本消化器外科学会誌. 23. 2175-2184 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 水本 龍二: "胆管細胞癌" 肝胆膵. 21. 531-536 (1990)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 水本 龍二: "胆嚢癌手術" 消化器外科. 14. 1233-1253 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 水本 龍二: "肝疾患治療ハンドブック「肝切除の術前、術後管理の基本」" 南江堂, 10 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] 水本 龍二: "外科学:肝臓ー解剖,生理,検査法" 朝倉書店, 15 (1991)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ryuji MIZUMOTO: "Surgical anatomy of the hepatic hilum with special reference to the caudate lobe" World J Surg. 12. 2-10 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ryuji MIZUMOTO: "The view of clinical medicine-surgery of the liver, biliary tract and pancreas" Japan Medical J. 3380. 15-21 (1989)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ryuji MIZUMOTO: "Present status of treatment for biliary tract cancer" J. Japan Biliary Association. 3. 373-377 (1989)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ryuji MIZUMOTO: "Preoperative estimation of operative risk and extension of operative indication in hepatic surgery" J. Japanese Gastroenterological Surg.23. 2175-2184 (1990)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ryuji MIZUMOTO: "Clinical problems on diagnosis and classification of cholangiocellular carcinoma of the liver, including cystic adenocarcinoma" KAN・TAN・SUI. 21. 531-536 (1990)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ryuji MIZUMOTO: "Operation for gall bladder carcinoma" Shokaki Geka. 14. 1233-1253 (1991)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ryuji MIZUMOTO: "Practical hand book. of treatment for liver diseases : Basic management before : and after hepatectomy" Nanko-do. 56-65 (1990)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ryuji MIZUMOTO: "Surgery : Liver-anatomy, Physiology and examination" Asakura-shoten. 3. 487-491

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1991 Final Research Report Summary
  • [Publications] Ryuji Mizumoto: "Surgical anatomy of the hepatic hilum with special reference to the caudate lobe" World J.Surg.12. 2-10 (1988)

    • Related Report
      1991 Annual Research Report
  • [Publications] 水本 龍二: "臨床医学の展望ー肝、胆道、膵外科" 日本医事新報. 3380. 15-21 (1989)

    • Related Report
      1991 Annual Research Report
  • [Publications] 水本 龍二: "胆道癌の治療ー現況と対策" 胆道. 3. 373-377 (1989)

    • Related Report
      1991 Annual Research Report
  • [Publications] 水本 龍二: "肝臓外科における手術危険度と手術適応の拡大" 日本消化器外科学会誌. 23. 2175-2184 (1990)

    • Related Report
      1991 Annual Research Report
  • [Publications] 水本 龍二: "胆管細胞癌" 粥胆膵. 21. 531-536 (1990)

    • Related Report
      1991 Annual Research Report
  • [Publications] 水本 龍二: "胆嚢癌手術" 消化器外科. 14. 1233-1253 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] 水本 龍二: "肝疾患治療ハンドブック「肝切除の術前、術後管理の基本」" 南江堂, 10 (1989)

    • Related Report
      1991 Annual Research Report
  • [Publications] 水本 龍二: "外科学・肝臓ー解剖、生理、検査法" 朝倉書店, 15 (1991)

    • Related Report
      1991 Annual Research Report
  • [Publications] Ryuji Mizumoto: "Surgical anatomy of the hepatic hilum with special reference to the caudate lobe." World J.Surg.12. 2-10 (1988)

    • Related Report
      1990 Annual Research Report
  • [Publications] 水本 龍二: "臨床医学の展望ー肝、胆道、膵外科" 日本医事新報. 3380. 15-21 (1989)

    • Related Report
      1990 Annual Research Report
  • [Publications] 水本 龍二: "胆道癌の治療ー現況と対策" 胆道. 3. 373-377 (1989)

    • Related Report
      1990 Annual Research Report
  • [Publications] 水本 龍二: "肝臓外科における手術危険度と手術適応の拡大" 日消外会誌. 23. 2175-2184 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] 水本 龍二: "胆管細胞癌" 肝胆膵. 21. 531-536 (1990)

    • Related Report
      1990 Annual Research Report
  • [Publications] 川原田 嘉文: "悪性閉塞性黄疸に対する術前減黄術の功罪ー実験的・臨床的検討" 腹部救急診療の進歩. 9. 33-37 (1989)

    • Related Report
      1990 Annual Research Report
  • [Publications] 水本 龍二: "肝疾患治療ハンドブック「肝切除の術前、術後管理の基本」" 南江堂, 10 (1989)

    • Related Report
      1990 Annual Research Report
  • [Publications] 水本 龍二: "臨床外科学「消化器外科学ー閉塞性黄疸」" 朝倉書店, 15 (1991)

    • Related Report
      1990 Annual Research Report
  • [Publications] Ryuji Mizumoto: "Surgical anatomy of the hepatic hilum with special reference to the caudate lobe." World J.Surg.12. 2-10 (1988)

    • Related Report
      1989 Annual Research Report
  • [Publications] 水本龍二: "肝切除と術後成績" 臨床と研究. 65. 125-131 (1988)

    • Related Report
      1989 Annual Research Report
  • [Publications] 水本龍二: "術後肝不全の病態と対策" 肝臓. 29. 136-138 (1988)

    • Related Report
      1989 Annual Research Report
  • [Publications] 川原田嘉文: "胆道癌の集学的治療" 癌と化学療法. 15. 763-769 (1988)

    • Related Report
      1989 Annual Research Report
  • [Publications] 川原田嘉文: "悪性閉塞性黄疸に対する術前減黄術の功罪-実験的臨床的検討" 腹部救急診療の進歩. 9. 33-37 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 野口孝: "脂質過酸化(free radical)と肝細胞障害" 肝胆膵. 19. 207-215 (1989)

    • Related Report
      1989 Annual Research Report
  • [Publications] 水本龍二: "消化器外科手術全書「肝臓の手術」" 南江堂, 35 (1986)

    • Related Report
      1989 Annual Research Report
  • [Publications] 水本龍二: "臨床生理学シリ-ズ5「肝臓」" 南江堂, 9 (1990)

    • Related Report
      1989 Annual Research Report

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Published: 1990-04-01   Modified: 2016-04-21  

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