Evaluation of a portocaval venograft and ameroid ring for the occlusion of intrahepatic portocaval shunts in dogs.
OBJECTIVE
To evaluate the use of a portocaval venograft and ameroid constrictor in the surgical management of intrahepatic portosystemic shunts (PSS).


METHODS
Prospective, clinical study.


METHODS
Ten client-owned dogs with intrahepatic PSS.


METHODS
Portal pressure was measured after temporary suture occlusion of the intrahepatic PSS. In dogs with an increase in portal pressure greater than 8 mm Hg, a single extrahepatic portocaval shunt was created using a jugular vein. An ameroid ring was placed around the venograft and the intrahepatic PSS was attenuated. Transcolonic pertechnetate scintigraphy was performed before surgery, 5 days after surgery, and 8 to 10 weeks after surgery. Dogs with continued portosystemic shunting were evaluated further by laparotomy or portography. Clinical outcome and complications were recorded.


RESULTS
Mean (+/- SD) portal pressure increased from 6 +/- 3 to 19 +/- 6 mm Hg with PSS occlusion; in all 10 dogs, the increase in portal pressure was greater than 8 mm Hg. There were no intraoperative complications, and, after creation of the portocaval shunt, the intrahepatic PSS could be completely ligated in 8 of 10 dogs. The final portal pressure was 9 +/- 4 mm Hg. Postoperative complications included coagulopathy and death (1 dog), ascites (3 dogs), and incisional discharge (3 dogs). Five of 8 dogs had continued portosystemic shunting at 8 to 10 weeks after surgery. Multiple extrahepatic PSS were demonstrated in 4 of these dogs. Clinical outcome was excellent in all 9 surviving dogs.


CONCLUSIONS
The surgical technique resulted in a high incidence of multiple extrahepatic PSS. Short-term clinical results were promising, but long-term outcome must be evaluated further.
Kyles
A E
AE
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA.
Gregory
C R
CR
Jackson
J
J
Ilkiw
J E
JE
Pascoe
P J
PJ
Adin
C
C
Samii
V F
VF
Herrgesell
E
E
D000818:Animals; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D004285:Dogs; D005260:Female; D007601:Jugular Veins / Q000637:transplantation; D008026:Ligation / Q000295:instrumentation / Q000662:veterinary; D008297:Male; D011168:Portal System / Q000002:abnormalities* / Q000601:surgery*; D011169:Portal Vein / Q000002:abnormalities / Q000601:surgery; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013536:Suture Techniques / Q000662:veterinary; D016896:Treatment Outcome