Mizumoto R, Kawarada Y, Yamawaki T, Noguchi T, Nishida S
Am J Surg. 1979 Jun;137(6):768-72. doi: 10.1016/0002-9610(79)90090-4.
Fifty-five dogs were used to evaluate the resectability of the liver with obstructive jaundice. Cholecystectomy and ligation of the distal common bile duct were used to produce obstructive jaundice. It was found that 40 per cent of the liver with obstructive jaundice was resectable with biliary decompression 2 weeks after ligation. At 1 week after induction of obstructive jaundice, 70 per cent hepatectomy with biliary decompression may be tolerated with careful postoperative management. From serum chemical studies it was found that if the serum albumin level was below 2.0 g/dl, 60 per cent of the dogs died after 40 per cent hepatectomy and all died after 70 per cent hepatectomy. From the standpoint of hepatic functional reserve 40 per cent hepatectomy is successful if the maximal removal rate of indocyanine green is above 0.14 mg/kg/min. Hepatic functional reserve is reliable for predicting the risk of hepatectomy, and it correlates well with the rate of hepatic regeneration after hepatectomy.
55只狗被用于评估伴有梗阻性黄疸的肝脏的可切除性。采用胆囊切除术和胆总管远端结扎术制造梗阻性黄疸。结果发现,在结扎后2周进行胆道减压的情况下,40%伴有梗阻性黄疸的肝脏是可切除的。在诱导梗阻性黄疸1周后,通过精心的术后管理,70%肝切除术并进行胆道减压可能被耐受。血清化学研究发现,如果血清白蛋白水平低于2.0g/dl,40%肝切除术后60%的狗死亡,70%肝切除术后全部死亡。从肝功能储备的角度来看,如果吲哚菁绿的最大清除率高于0.14mg/kg/min,40%肝切除术是成功的。肝功能储备对于预测肝切除风险是可靠的,并且与肝切除术后的肝再生率密切相关。