Doppman J L, Girton M, Vermess M
Radiology. 1982 Apr;143(1):37-43. doi: 10.1148/radiology.143.1.7063748.
Rhesus and cynomolgus monkeys were used as experimental subjects to determine the extend to which the presence of biliary obstruction increases the risk of hepatic necrosis following hepatic artery embolization. It was found that peripheral hepatic artery embolization without biliary obstruction resulted in acute hepatic swelling and dysfunction and chronic focal infarction with bile cyst formation. However, massive hepatic necrosis and bile lakes were not seen. Distal common bile duct obstruction unaccompanied by arterial occlusion did not seriously damage the liver, although it was found that distal common duct obstruction in monkeys is not strictly comparable to distal common duct obstruction in humans. When peripheral hepatic artery embolization was performed following ligation of the right or left hepatic ducts at the point of their emergence from the porta hepatis, total infarction of the obstructed segment occurred and a massive bile lake formed. The pathophysiologic explanation is probably the decreased portal venous inflow that accompanies biliary obstruction; hepatic artery inflow reciprocally increases and the liver become critically dependent upon an intact arterial system. Clinical evidence suggests that a liver with a recently decompressed biliary tree may also be more susceptible to infarction and abscess formation following hepatic artery ligation or embolization.
恒河猴和食蟹猴被用作实验对象，以确定胆道梗阻的存在在多大程度上增加了肝动脉栓塞后肝坏死的风险。研究发现，无胆道梗阻的肝外周动脉栓塞会导致急性肝脏肿大和功能障碍以及伴有胆囊形成的慢性局灶性梗死。然而，未见到大面积肝坏死和胆汁湖。尽管发现猴子的胆总管远端梗阻与人类的胆总管远端梗阻并不完全可比，但未伴有动脉闭塞的胆总管远端梗阻并未严重损害肝脏。当在肝门处左右肝管从肝门发出的部位结扎后进行肝外周动脉栓塞时，梗阻段会发生完全梗死并形成巨大的胆汁湖。病理生理学解释可能是胆道梗阻伴随门静脉血流减少；肝动脉血流相应增加，肝脏变得严重依赖完整的动脉系统。临床证据表明，胆道树近期减压的肝脏在肝动脉结扎或栓塞后也可能更容易发生梗死和脓肿形成。
