Direct intrahepatic portacaval shunt: an experimental study.
OBJECTIVE
To determine the feasibility of creating direct intrahepatic portacaval shunt (DIPS) in swine with puncture under sonographic guidance.


METHODS
DIPS was created in 10 domestic swine under sonographic guidance. Liver function, blood ammonia level and portosystemic gradient (PSG) were compared before and after the procedure. Patency of shunt was followed by portography every 7 days after DIPS.


RESULTS
DIPS was successfully established in all 10 swine without any complications. One day after procedure the alanine aminotransferase (ALT), aspartate aminotransferase (AST), and blood ammonia level (BAL) of swine rose from 5.40+/-0.69, 16.00+/-0.79 and 35.66+/-4.10 to 34.20+/-3.46, 59.70+/-2.22 and 66.94+/-3.44 respectively. (P<0.05). The PSG decreased from 0.59+/-0.20 kPa to 0.24+/-0.11 kPa after DIPS (P<0.05). The shunt of 10 swine was kept patent from 7-28 days (median patency time was 14 days).


CONCLUSIONS
This initial experience demonstrated that creating intrahepatic portacaval shunt from retrohepatic segment of IVC to portal vein with puncture under sonographic guidance in swine is safe and feasible. Further studies are necessary to perform DIPS in cirrhosis patients.
Luo
Jian-Jun
JJ
Deatrtment of Radiology, Affiliated Zhongshan Hospital, Medical Center of Fundan University, 180 Fenglin Road, Shanghai 200032, China. luojj2001@yahoom.com
Yan
Zhi-Ping
ZP
Zhou
Kang-Rong
KR
Qian
Sheng
S
D000818:Animals; D005240:Feasibility Studies; D008099:Liver / Q000000981:diagnostic imaging* / Q000601:surgery*; D011167:Portacaval Shunt, Surgical; D011677:Punctures; D011860:Radiography, Abdominal; D015607:Stents; D025321:Surgery, Computer-Assisted; D013552:Swine; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography