Lu M D, Liang L J, Huang J F, Ye W J, Yang Q S, Peng B G, Xie X Y
Department of Hepatobiliary Surgery, First Affiliated Hospital, Sun Yet-Sen University of Medical Sciences, Guangzhou, China.
Surg Today. 1995;25(5):416-20. doi: 10.1007/BF00311818.
We devised a method for portal vein embolization with ethanol injection (PVEEI) via a fine needle. Both the efficacy and safety of this procedure were evaluated in 28 dogs. An embolization of the left central and lateral lobes was undertaken with various doses of absolute (95%) ethanol. The smallest dose, 0.25 ml/kg ethanol (n = 7), caused the least damage to the liver, but the embolization was not complete. At the highest dose at 1.0 ml/kg, four of the seven dogs died of respiratory arrest; however, embolization was complete in the remaining dogs. All animals tolerated the procedure by 0.5 ml/kg ethanol (n = 11) with a satisfactory embolic effect, slight toxicity to the hepatic parenchyma, and only transient changes in liver function. The results suggested that PVEEI is safe and effective when a suitable dose of ethanol is administered. Local overembolization occurred in one dog due to extension of the thrombus, suggesting that the point of puncture should not be near the confluence of the branches. Since a selective portal venous puncture is not difficult to perform under sonographic guidance, PVEEI is expected to be clinically applied.
我们设计了一种通过细针注射乙醇进行门静脉栓塞术（PVEEI）的方法。在28只犬中评估了该手术的有效性和安全性。使用不同剂量的无水（95%）乙醇对左中叶和外侧叶进行栓塞。最小剂量为0.25 ml/kg乙醇（n = 7），对肝脏造成的损伤最小，但栓塞不完全。在最高剂量1.0 ml/kg时，7只犬中有4只死于呼吸骤停；然而，其余犬的栓塞是完全的。所有动物对0.5 ml/kg乙醇（n = 11）的手术耐受性良好，栓塞效果满意，对肝实质毒性轻微，肝功能仅有短暂变化。结果表明，当给予合适剂量的乙醇时，PVEEI是安全有效的。一只犬因血栓延伸发生局部过度栓塞，提示穿刺点不应靠近分支汇合处。由于在超声引导下进行选择性门静脉穿刺并不困难，PVEEI有望在临床上得到应用。
