| Research Abstract |
We have evaluated whether hepatic artery-portal vein shunt is useful for the treatment of hepatic failure when hepatic blood flow is blocked, using adult cross-bred (hybrid) dogs.
[Subjects and Methods] We prepared two groups of animals ; in the first group, hepatic artery was ligated and resected, i.e., hepatic artery blockage group (blockage group, n=8), and in the second group, the resected hepatic artery was directly anastomosed to partal vein, i.e., partial portal arterialization group (arterialization group, n=12). Portal vein pressure, partial oxygen pressure of portal vein, portal vein blood flow, blood flow in liver tissues and hepatic energy metabolism (AKBR) were measured preoperatively, immediately after surgery, 30 and 60 minutes after surgery, and then, two groups were compared.
[Results] (1) Portal vein pressure (mm Hg) : In the arterialization group, portal vein pressure was 6.6 mg Hg before surgery, 8.3,8.7,8.3 after surgery. In the blockage group, portal vein pressure w
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as 5.9 mg Hg before surgery, 6.8,5.4,6.3 after surgery. No significant differences were detected between the two groups. (2) Partial oxygen pressure of the portal vein (mmHg) : Partial oxygen pressure of the portal vein was 47.1 mm Hg before surgery, 51.9,55.7,51.4 after surgery, in the arterialization group. In the blockage group, partial oxygen pressure of the portal vein was 51.1 mm Hg before surgery, 48.2,46.7,49.2 after surgery. In the arterialization group, partial oxygen pressure of the portal vein tended to increase, but no significant differences were detected between the two groups. However, when D PO_2(%) was calcuated, assuming that the preoperative level was 100%, the partial oxygen pressure of the portal vein was significantly higher in the arterialization group than in the blockage group (p<0.05). (3) Portal vein blood flow (ml/min.) : In the arterialization group, portal vein blood flow was 271.4 ml/min before surgery, 410.0,400.0,325.0 after surgery. In the blockage group, portal vein blood flow was 410.0 before surgery, 324.0,243.3,237.8 after surgery. In the arterialization group, portal vein blood flow tended to increase, whereas portal vein blood flow tended to decrease in the blockage group. No significant differences were detected between the two groups. However, when D portal vein blood flow (%) was calculated, assuming that the preoperative level was 100%, the portal vein blood flow was significantly higher in the arterialization group than in the blockage group (p<0.05). (4) AKBR : In the arterialization group, AKBR was 1.0 preoperatively, 1.1,0.9,0.8 after surgery. In the blockage group, AKBR was 1.2 preoperatively, 1.3,1.2,1.6 after surgery. No significant differences were detected between the two groups. (5) Blood flow in hepatic tissues (ml/min/100 mg) : In the arterialization group, blood flow in hepatic tisswues was 18.0 preoperatively, 15.6,14.1,9.3 after surgery. In the blockage group, blood flow in hepatic tissues was 15.6 preoperatively, 15.8,15.8,12.2 after surgery. No significant differences were detected between the two groups.
[Discussion] The rates of changes in partial oxygen pressure of portal vein and portal vein blood flow were significantly higher in the arterialization group than in the blockage group (p<0.05), assuming that the preoperative level was 100%. These findings indicate that hepatic artery-portal vein shunt allows to maintain hepatic blood flow and oxygen supply following the blockage of hepatic artery and is useful for preventing hepatic failure. Less
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