Experimental study on hepatic vascular exclusion with atrioportacaval shunt in dogs.

The main effects of hepatic vascular exclusion (HVE) on the body are hemodynamic changes and metabolic disorders. We developed a new technique--atrioportacaval shunt (APCS) both to increase the blood--return volume and to decompress the portal system and the inferior vena cava below the occlusion during HVE in canine. Experimental results showed that HVE-APCS is characteristic of simplicity and safety. During HVE-APCS central venous pressure (CVP), mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), pulmonary capillary wedged pressure (PCWP) and pulmonary vascular resistance (PVR) remained almost stable while cardiac output (CO) decreased by 34.5-45.6% and systemic vascular resistance (SVR) increased by 46.8-65.7%. The recirculation injury to ischemic liver was mild owing to concomitant decompression of the portal system. It may be concluded that HVE-APCS is an ideal method to control the bleeding from the major hepatic veins and retrohepatic vena cava.