Chen Yong-liang, Li Wen-gang, Huang Zhi-qiang, Huang Xiao-qiang, Chen Ming-yi, Duan Wei-dong
Department of Hepatobiliary Surgery, General Hospital of People's Liberation Army, Bejing 100853, China.
Chin Med J (Engl). 2008 Jul 20;121(14):1302-6.
A fatal complication after liver transplantation is anastomotic embolization of the hepatic artery. In order to solve this problem, the portal venous arterialization (PVA) is used to reconstruct the hepatic arterial blood flow. The purpose of this study was to investigate the influence of PVA on rats with acute occlusion of hepatic artery.
Rat PVA models were established and then randomly divided into Group 1 (control group), Group 2 (jaundice group), Group 3 (bile duct recanalization group), and Group 4 (portal vein arterilization group). Recanalization of the common bile duct and PVA were performed 5 days after bile duct ligation in the rats. The influence of the PVA on general conditions, hepatic changes of structure and function, portal vein pressure and hepatic micrangium were observed for one month.
Five days after common bile duct ligation the serum bilirubin, transaminase and alkaline phosphatase levels were significantly increased. Compared with group 1, there was a statistically significant difference (P < 0.01). These rats then underwent bile duct recanalization and PVA. After a month, the liver functions and microscopic structures completely returned to normal and, compared with group 1, there was no statistically significant difference in portal vein pressure (P > 0.05). Vascular casting samples showed that hepatic sinusoids were slightly thicker and more filled than normal ones and although they had some deformations, the hepatic sinusoids were still distributed around the central vein in radial form.
Within a month after operation, bile duct recanalization and PVA do not show obvious adverse effects on liver hemodynamics and hepatic micrangium, and the liver function and microscopic structure can return to normal.
肝移植术后一种致命的并发症是肝动脉吻合口栓塞。为了解决这一问题,采用门静脉动脉化(PVA)来重建肝动脉血流。本研究的目的是探讨PVA对肝动脉急性闭塞大鼠的影响。
建立大鼠PVA模型,然后随机分为第1组(对照组)、第2组(黄疸组)、第3组(胆管再通组)和第4组(门静脉动脉化组)。大鼠胆管结扎术后5天进行胆总管再通和PVA。观察PVA对大鼠一般情况、肝脏结构和功能变化、门静脉压力及肝微血管的影响,为期1个月。
胆管结扎术后5天,血清胆红素、转氨酶和碱性磷酸酶水平显著升高。与第1组相比,差异有统计学意义(P < 0.01)。这些大鼠随后进行了胆管再通和PVA。1个月后,肝功能和微观结构完全恢复正常,与第1组相比,门静脉压力差异无统计学意义(P > 0.05)。血管铸型样本显示,肝血窦比正常的略粗且更充盈,虽然有一些变形,但肝血窦仍以放射状分布在中央静脉周围。
术后1个月内,胆管再通和PVA对肝脏血流动力学和肝微血管无明显不良影响,肝功能和微观结构可恢复正常。