Surgical management of left-divisional intrahepatic portosystemic shunts: outcome after partial ligation of, or ameroid ring constrictor placement on, the left hepatic vein in twenty-eight dogs (1995-2005).
OBJECTIVE
To evaluate outcome in dogs with left divisional intrahepatic portosystemic shunts (PSS) treated by partial ligation (PL) or ameroid ring constrictor (ARC) placement on the left hepatic vein.


METHODS
Retrospective study.


METHODS
Dogs (n=28) with left divisional intrahepatic PSS.


METHODS
Retrieved data from medical records of dogs with left divisional intrahepatic PSS that had PL (n=17) or ARC (n=11) were signalment, history, clinical signs, preoperative blood work, portal pressure measurements, ARC size, complications and postoperative technetium scintigraphy. Outcome assessed by owner interview 6 months-10 years after surgery was classified as excellent, good or poor. Differences were tested by exact chi2 test.


RESULTS
Major complications occurred in 3 dogs: coagulopathy (1 PL dog died), ascites (1 PL dog survived) and seizures (1 ARC dog died). Eight PL dogs had technetium portal scintigraphy; 1 dog was negative and 7 dogs positive for persistent shunting. Seven ARC dogs had scintigraphy; 4 dogs were negative and 3 positive for persistent shunting. In PL dogs, long-term clinical outcome was excellent (92%) or good (8%) whereas, in ARC dogs it was excellent (20%), good (50%) or poor (30%). This outcome difference between treatment groups was significant (P=.0012).


CONCLUSIONS
Dogs treated by PL had significantly better long-term outcome compared with ARC treated dogs.


CONCLUSIONS
Based on these data, ARC placement on the left hepatic vein in dogs with left-divisional intrahepatic PSS cannot be recommended.
Mehl
Margo L
ML
Department of Surgical and Radiological Sciences, the Veterinary Medical Teaching Hospital, University of California-Davis, Davis, CA 95616, USA. mmehl@ucdavis.edu
Kyles
Andrew E
AE
Case
Joseph B
JB
Kass
Philip H
PH
Zwingenberger
Allison
A
Gregory
Clare R
CR
D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002364:Caseins; D003250:Constriction; D004285:Dogs / Q000002:abnormalities / Q000601:surgery; D005260:Female; D006503:Hepatic Veins / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D020100:Hydrogels; D008026:Ligation / Q000379:methods / Q000662:veterinary*; D008297:Male; D011168:Portal System / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality / Q000662:veterinary; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging / Q000662:veterinary; D012189:Retrospective Studies; D016896:Treatment Outcome
D001672:Biocompatible Materials; D002364:Caseins; D020100:Hydrogels; C009719:ameroid