Asakawa H, Kasai S, Mito M
Jpn J Surg. 1985 Jul;15(4):291-8. doi: 10.1007/BF02469920.
The effects of portal arterialization after portacaval shunt were studied in dogs. Flow- and pressure-adapted portal arterialization was performed by mounting a Teflon cuff on an autogenous vein bypass graft between the hepatic stump of the portal vein and the right renal artery. Immediately following operation, the total hepatic blood flow and intrahepatic portal venous pressure were within normal range. Eight weeks after operation, the intrahepatic portal venous pressure remained within the preoperative range, while total hepatic blood flow had increased double or triple. However, structural change due to increased flow was absent in the liver, even sixteen months after operation. Body weight, liver enzyme chemistry, ICG clearance rate, and amino acid metabolism were well maintained for the entire period of investigation. These findings suggest that sequelae such as hepatic encephalopathy and impaired hepatic metabolism after portacaval shunt can be avoided by portal arterialization, in the presence of an appropriate flow and pressure.
在犬类动物中研究了门腔分流术后门静脉动脉化的效果。通过在门静脉肝残端与右肾动脉之间的自体静脉搭桥移植物上安装一个特氟龙袖带，进行流量和压力适应性门静脉动脉化。术后即刻，肝脏总血流量和肝内门静脉压力在正常范围内。术后8周，肝内门静脉压力仍保持在术前范围内，而肝脏总血流量增加了两倍或三倍。然而，即使在术后16个月，肝脏中也未出现因血流量增加而导致的结构变化。在整个研究期间，体重、肝酶化学指标、吲哚菁绿清除率和氨基酸代谢均保持良好。这些发现表明，在存在适当流量和压力的情况下，门静脉动脉化可避免门腔分流术后诸如肝性脑病和肝脏代谢受损等后遗症。
