Polat Dilek, Rizalar Riza, Tander Burak, Yildiz Levent, Aritürk Ender, Bernay Ferit
Department of Pediatric Surgery, Ondokuzmayis University, Samsun, Turkey.
Pediatr Surg Int. 2004 Jun;20(6):434-8. doi: 10.1007/s00383-004-1171-1. Epub 2004 Apr 20.
The purpose of this study was to determine whether splenohepatopexy (SHP) or omental transposition (OP) could reverse the portal hypertension (PH) induced by portal vein ligation (PVL). Fifty-eight Wistar rats divided into four groups: in group A (22 rats) PH was produced by calibrated PVL. In group B (8 rats), SHP was performed. Group C animals (13 rats) underwent SHP and PVL. In group D (15 rats) both PVL and OP were done. In all of the rats, the portal pressures (PP) were measured before and after the production of PVL. For SHP, small areas on the spleen and liver capsula were stripped off, and these two areas were placed together. In group D, an omentum patch was tied on the prepared liver surface. Twelve weeks after surgery, the PP were measured again and portal angiography was done. The liver, omentum and spleen were histopathologically examined. In all of the groups, the PP after PVL were significantly higher than before PVL. Twelve weeks after surgery, the PP of SHP and OP groups were significantly lower than those with PVL alone. Angiographic study showed many collaterals between transposed tissue and liver. Histopathologically, the collaterals of animals with SHP or OP were found to be well developed to allow sufficient flow for PP reduction. Both SHP and OP may reverse the increased PP in PVL model of PH. In the future; these methods may be alternative techniques for PP reduction in human beings as well.
本研究的目的是确定脾肝固定术（SHP）或网膜移位术（OP）是否能逆转门静脉结扎（PVL）诱导的门静脉高压（PH）。58只Wistar大鼠分为四组：A组（22只大鼠）通过校准的PVL产生PH。B组（8只大鼠）进行SHP。C组动物（13只大鼠）接受SHP和PVL。D组（15只大鼠）同时进行PVL和OP。在所有大鼠中，在PVL产生前后测量门静脉压力（PP）。对于SHP，将脾脏和肝包膜上的小区域剥离，然后将这两个区域放在一起。在D组中，将一块网膜贴片系在准备好的肝脏表面。术后12周，再次测量PP并进行门静脉血管造影。对肝脏、网膜和脾脏进行组织病理学检查。在所有组中，PVL后的PP均显著高于PVL前。术后12周，SHP组和OP组的PP显著低于单纯PVL组。血管造影研究显示，移位组织与肝脏之间有许多侧支循环。组织病理学检查发现，接受SHP或OP的动物的侧支循环发育良好，足以提供足够的血流以降低PP。SHP和OP都可能逆转PH的PVL模型中升高的PP。未来，这些方法也可能成为人类降低PP的替代技术。
