Luo M D, Dai Z B
Department of Surgery, Tongji Hospital, Tongji Medical University, Wuhan.
Chin Med J (Engl). 1994 Nov;107(11):850-3.
To evaluate the effect of hepatic inflow occlusion on the liver remnant, three methods of inflow occlusion of the right outside lobe of liver, which was finally resected, were performed in 30 rabbits. The mortality rate of 12 animals (6 in Group I and 6 in Group II) undergone 30 minutes of portal triad clamping (PTC) and selective hepatic artery reserving (SHAR) was both 66.7%. No death occurred in Group III (PTC, n = 6) and IV (SHAR, n = 6) for 20 minutes of hepatic ischemia, but with an irreversible damage to the hepatocytes. The level of serum glutamic-pyruvic transaminase (GPT) in Groups III and IV animals rose to 282.17 U/L and 155.33 U/L on the first postoperative day and thereafter declining slowly to the preoperative level on the 5th and 3rd days, respectively. In Group V with selective hemihepatic vascular occlusion (SHHVO) serum GPT showed only temporary mild rise (112.83 U/L) on the first postoperative day and no hepatic pathologic change appeared. It is obvious that the function of the liver remnant can be best preserved during hepatic resection under SHHVO.
为评估肝血流阻断对剩余肝脏的影响，对30只家兔采用3种方法阻断最终要切除的肝右外叶的血流。12只动物（I组和II组各6只）接受30分钟门静脉三联钳夹（PTC）和保留选择性肝动脉（SHAR），其死亡率均为66.7%。III组（PTC，n = 6）和IV组（SHAR，n = 6）进行20分钟肝缺血时无死亡发生，但肝细胞出现不可逆损伤。III组和IV组动物术后第1天血清谷丙转氨酶（GPT）水平分别升至282.17 U/L和155.33 U/L，之后分别在第5天和第3天缓慢降至术前水平。V组采用选择性半肝血管阻断（SHHVO），术后第1天血清GPT仅出现短暂轻度升高（112.83 U/L），且未出现肝脏病理改变。显然，在SHHVO下进行肝切除时，剩余肝脏的功能能得到最佳保留。
