Brölsch C, Grün M, Neuhaus P, Andreczewski W
Chir Forum Exp Klin Forsch. 1980:161-5.
Hepatic hemodynamic alterations following various porta-systemic shunting procedures were evaluated in the normal and cirrhotic rat liver using a microsphere embolization method. The aim of the study was to differentiate the hepatic arterial and portal venous contribution in a defined cirrhotic rat liver model following total shunting procedures and to determine residual portal blood supply after selective shunt procedures intended to prevent post shunt liver failure. Experimentally selective shunt procedures such as mesentericocaval shunt, splenocaval shunt, portacaval transposition and even portacaval side/side shunting lead to improved hepatic blood supply compared with total end/side shunting. Improvement of liver blood supply is caused rather by arterial compensation than by residual portal blood perfusion. The amount of portal blood supply is not related to a specific type of selective shunt. Evaluation of hepatic arterial compensatory capacity is a more reliable method of predicting total liver blood supply following any shunt procedure.
采用微球栓塞法,对正常大鼠和肝硬化大鼠肝脏在各种门体分流术后的肝血流动力学改变进行了评估。本研究的目的是在完全分流术后的特定肝硬化大鼠肝脏模型中区分肝动脉和门静脉的贡献,并确定旨在预防分流后肝衰竭的选择性分流术后的残余门静脉血供。实验性选择性分流术,如肠系膜上腔静脉分流术、脾腔静脉分流术、门腔静脉转位术,甚至门腔静脉侧侧分流术,与完全端端分流术相比,可改善肝脏血液供应。肝脏血液供应的改善更多是由动脉代偿引起的,而非残余门静脉血流灌注。门静脉血供量与特定类型的选择性分流无关。评估肝动脉代偿能力是预测任何分流术后肝脏总血液供应的更可靠方法。