Experimental Studies on the Catheter-bypass Methods for Maintaining the Hepatic Circulatin under Complete Blokage of the Hepatoduodenal Ligament

Toshiaki Kimura

First Department of Surgery, Okayama University Medical School

Bypass circulation for maintaining proper hepatic circulation during total clamping of the hepatoduodenal ligament was studied in mongrel dogs. Three experimental groups were prepared: a group with no hepatic inflow under total clamping of the hepatoduodenal ligament, accompanied by portal vein-inferior vena cava (IVC) bypass to portal congestion; a group with double bypass which consisted of both iliac artery-proximal portal vein and distal portal vein-IVC; and a group with a single portal vein-portal vein bypass. Total clamping of the hepatoduodenal ligament immediately decreased the levels of ATP and energy charge in the liver. In the double bypass group, the hepatic blood inflow, hepatic tissue blood flow, tissue oxygen pressure, and the levels of both ATP and energy charge in the liver were maintained at normal levels, with no significant systemic circulatory dynamic or histologic changes. In the single bypass group, hepatic blood inflow, hepatic tissue blood flow and tissue oxygen pressure were decreased, although normal ATP and energy charge levels were maintained. The double catheter bypass method proved to be exellent for maintaining hepatic function and portal congestion during temporary clamping of the hepatoduodenal ligament. The single catheter bypass method was not satisfactory for maintaining hepatic circulation.

Key words
hepatoduodenal ligament, hepatic circulation, hepatic ischemia, catheter bypass, portal arterialization

Reprint requests
Toshiaki Kimura First Department of Surgery, Okayama University Medical School
2-77 Saga, Hirao-cho, Kumage-gun, Yamaguchi, 742-11 JAPAN

Accepted
March 13, 1991

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