[Experimental study on catheter-bypass between superior mesenteric and hepatic hilar portal veins (SMV-HPV bypass)].
Hepatic ischemia is a consequence of concomitant resection of the portal vein and the hepatic artery when it is necessitated in hepatobiliary or pancreatic surgery. We developed an antithrombogenic catheter with a balloon and experimentally evaluated the safety of construction of SMV-HPV bypass using this catheter to simultaneously prevent intestinal vascular congestion and hepatic ischemia. The main portal vein and the hepatic artery were blocked and SMV-HPV shunting was made in five dogs (bypass group); the main portal vein and the hepatic artery were blocked and the SMV was shunted to the femoral vein in others (ischemia group). In the ischemia group, 3 of the 5 dogs died within 5 days, but all animals of the bypass group survived for a long period. In the bypass group, the changes of adenine nucleotide levels, energy charge ratio, liver function, blood coagulation, and fibrinolysis were mild and within physiologic ranges, and none of changes of the hepatic tissue were observed histologically. This bypass procedure is simple and safe to simultaneously prevent hepatic ischemia and intestinal vascular congestion in cases requiring concomitant resection and reconstruction of the portal vein and the hepatic artery.
Kasuga
T
T
Department of Surgery II, Nagoya University, School of Medicine, Japan.
Nakao
A
A
D000818:Animals; D002404:Catheterization / Q000295:instrumentation*; D004285:Dogs; D007511:Ischemia / Q000601:surgery*; D008099:Liver / Q000098:blood supply*; D008642:Mesenteric Veins / Q000601:surgery*; D011169:Portal Vein / Q000601:surgery*