Baer H U, Guastella T, Wheatley A M, Zimmermann A, Blumgart L H
Department of Visceral and Transplantation Surgery, University of Berne, Inselspital, Switzerland.
J Hepatol. 1993 Nov;19(3):377-82. doi: 10.1016/s0168-8278(05)80545-8.
The aim of this study was to define the effects of hepatic resection on liver blood flow and portal pressure in the presence of obstructive jaundice. Liver blood flow and portal pressure were measured in 17 jaundiced animals (5 days bile duct ligation) and 16 control animals. A 70% liver resection with or without hepatic artery ligation was performed in the control animals. On day 5, the animals underwent a second operation. Hepatic artery ligation alone was performed in a group of control animals. In jaundiced rats there was a decrease in liver blood flow (1.24 +/- 0.23 ml/min per g vs. normal 1.91 +/- 0.38 ml/min per g, P < 0.01) and an increase in portal pressure (11.2 +/- 3.47 mmHg vs. normal 6.93 +/- 1.01 mmHg, P < 0.01). After partial hepatectomy, a significant increase in liver blood flow was observed in controls (2.44 +/- 0.74 ml/min per g, P < 0.01) but not in jaundiced rats. Hepatic artery ligation did not affect blood flow or portal pressure either before or after resection. Small but significant portal-systemic shunting was found in all jaundiced rats (2.19 +/- 2.1% vs. 0.026 +/- 0.015%, P < 0.05). These results demonstrate that partial hepatectomy results in a significant increase in total liver blood flow. Acute cholestasis appears to prevent this increase. Even in the early stages of obstructive jaundice in the rat, there were signs of portal-systemic shunts.
本研究的目的是确定在存在梗阻性黄疸的情况下肝切除对肝血流和门静脉压力的影响。对17只黄疸动物（胆管结扎5天）和16只对照动物测量肝血流和门静脉压力。对对照动物进行70%肝切除，伴或不伴肝动脉结扎。在第5天，动物接受第二次手术。一组对照动物仅进行肝动脉结扎。在黄疸大鼠中，肝血流减少（1.24±0.23ml/min per g，正常为1.91±0.38ml/min per g，P<0.01），门静脉压力升高（11.2±3.47mmHg，正常为6.93±1.01mmHg，P<0.01）。部分肝切除术后，对照动物肝血流显著增加（2.44±0.74ml/min per g，P<0.01），但黄疸大鼠未出现。肝动脉结扎在切除前后均不影响血流或门静脉压力。在所有黄疸大鼠中均发现少量但显著的门体分流（2.19±2.1%，而正常为0.026±0.015%，P<0.05）。这些结果表明，部分肝切除术可导致肝总血流显著增加。急性胆汁淤积似乎可阻止这种增加。即使在大鼠梗阻性黄疸的早期阶段，也存在门体分流的迹象。
