| Project/Area Number |
01570749
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | KANAZAWA UNIVERSITY |
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Principal Investigator |
UENO Keiichi SCHOOL OF MEDICINE, KANAZAWA UNIVERSITY, DEPARTMENT OF SURGERY(II), INSTRUCTOR,, 助手 (30184948)
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| Co-Investigator(Kenkyū-buntansha) |
OHTA Tetsuo SCHOOL OF MEDICINE, KANAZAWA UNIVERSITY, DEPARTMENT OF SURGERY(II), INSTRUCTOR, 助手 (40194170)
NAGAKAWA Takukazu SCHOOL OF ALLIED MEDICAL PROFESSIONS, DANAZAWA UNIVERSITY, PROFESSOR, 医療技術短期大学部, 教授 (50019600)
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| Project Period (FY) |
1989 – 1991
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| Project Status |
Completed (Fiscal Year 1991)
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| Budget Amount *help |
¥2,200,000 (Direct Cost: ¥2,200,000)
Fiscal Year 1991: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1990: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1989: ¥1,200,000 (Direct Cost: ¥1,200,000)
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| Keywords | HEPATIC HILAR CARCINOMA / HEPATIC ARTERIAL LIGATION / TOTAL HEPATODUODENAL LIGAMENTECTOMY / PARTIAL ARTERIALIZATION OF THE PORTAL VEIN / HEPATIC BLOOD FLOW / BLOOD PUMP FOR EXTRACORPOREAL CIRCULATION |
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| Research Abstract |
Total hepatoduodenal ligamentectomy for hepatic hilar carcinoma can increase curability. This procedure includes resections of the hepatic artery and the portal vein. However, the incidence of postoperative complication is very high. For preventing these postoperative hepatic failures, we instigated the use of partial arterialization of the portal vein during and after the operation. This procedure was first performed on dogs in 1989. Partial arterialization of portal vein effectively preserved the liver function during the operation and in the early period (3 hours) after dissection of the hepatic artery. In 1990, we could preserve the liver function for up to 12 hours after dissection. Both in 1989 and in 1990 we employed use of a mechanical biopump (extracorporeal circulation system) to exact circulation. In the final year of this project, 1991, we improved the efficacy of partial arterialization of the portal vein by using a 9-Fr urokinase immobilized catheter between the intrahepatic portal vein and the femoral artery. The bypass flow was about 100 ml/min. In 1989 we proved that 100 ml/min was the optimum flow to maintain liver function. This catheter maintained hepatic flow and hepatic oxygen supply for 7 days. Serum transaminase level increased temporary but normalized after 7 days. Energy charge in hepatic tissue stayed in the normal range. Finally we proved the efficacy of partial arterialization of the portal vein for countermeasuring postoperative failure after total hepatoduodenal ligamentectomy.
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