White R N, Burton C A, McEvoy F J
Department of Small Animal Medicine and Surgery, Royal Veterinary College, University of London, Hatfield, Hertfordshire.
Vet Rec. 1998 Apr 4;142(14):358-65. doi: 10.1136/vr.142.14.358.
The surgical attenuation of an intrahepatic portosystemic shunt in 45 dogs is described. Twenty-nine (64 per cent) had left divisional shunts consistent with a patent ductus venosus (PDV), 15 (33 per cent) had central divisional shunts and one had a right divisional shunt. In the dogs with a PDV, the shunt vessel could be most easily manipulated at a posthepatic site, whereas in those with central and right divisional shunts the manipulation could be more easily made intrahepatically but sometimes involved demanding intravascular surgical techniques. Eight dogs (18 per cent) died during the surgery or shortly afterwards. Of the 37 dogs surviving longer term, 28 (76 per cent) became clinically normal and required no medication or diet control. In a further three animals the shunt was ligated completely only during a second surgical procedure. The remaining six dogs were euthanased because of clinical signs of encephalopathy which were either surgically or medically uncontrollable.
本文描述了45只犬肝内门体分流的手术减流情况。其中29只（64%）存在与静脉导管未闭（PDV）相符的左叶分流，15只（33%）存在中央叶分流，1只存在右叶分流。在患有PDV的犬中，分流血管在肝后部位最易操作，而在患有中央叶和右叶分流的犬中，操作在肝内更容易进行，但有时需要复杂的血管内手术技术。8只犬（18%）在手术期间或术后不久死亡。在37只长期存活的犬中，28只（76%）临床症状恢复正常，无需药物治疗或饮食控制。另有3只动物仅在第二次手术时才完全结扎分流。其余6只犬因出现手术或药物无法控制的肝性脑病临床症状而实施安乐死。
