Shimizu Y, Miyazaki M, Shimizu H, Ito H, Nakagawa K, Ambiru S, Yoshidome H, Nakajima N
First Department of Surgery, School of Medicine, Chiba University, Japan.
Br J Surg. 2000 Jun;87(6):784-9. doi: 10.1046/j.1365-2168.2000.01382.x.
Extended hepatectomy may result in postoperative liver failure. The aim of this study was to evaluate the effects of arterialization of the portal vein on oxygen supply, hepatic energy metabolism and liver regeneration after extended hepatectomy.
Portal haemodynamics were evaluated 0 or 10 days after arterialization of the portal vein in three experimental groups: 85 per cent partial hepatectomy, 85 per cent partial hepatectomy 10 days after arterialization of the portal vein and 85 per cent partial hepatectomy 10 days after ligation of the hepatic artery. Survival rates, weight of the regenerating liver, levels of adenine nucleotides and hepatic energy charge were assessed.
Arterialization of the portal vein caused a significant increase in partial pressure of oxygen and oxygen saturation. Portal blood flow 10 days after arterialization was significantly increased. Survival rate and weight of the regenerating liver in the group with arterialization of the portal vein were significantly higher than those in the other two groups. The group with arterialization of the portal vein showed the highest levels of adenosine 5'-triphosphate.
The increase in portal blood flow and oxygen supply produced by arterialization of the portal vein has beneficial effects on hepatic energy metabolism and liver regeneration, and leads to improved survival after experimental extended hepatectomy.
扩大肝切除术后可能导致肝功能衰竭。本研究旨在评估门静脉动脉化对扩大肝切除术后肝脏氧供、能量代谢及肝再生的影响。
在三个实验组中，于门静脉动脉化后0天或10天评估门静脉血流动力学：85%肝部分切除术、门静脉动脉化10天后行85%肝部分切除术以及肝动脉结扎10天后行85%肝部分切除术。评估生存率、再生肝重量、腺嘌呤核苷酸水平及肝脏能量负荷。
门静脉动脉化导致氧分压和氧饱和度显著升高。动脉化10天后门静脉血流量显著增加。门静脉动脉化组的生存率和再生肝重量显著高于其他两组。门静脉动脉化组的三磷酸腺苷水平最高。
门静脉动脉化所产生的门静脉血流量增加及氧供增加对肝脏能量代谢和肝再生具有有益作用，并可提高实验性扩大肝切除术后的生存率。
