Experimental Studies on Arterio-Portal Shunt-For Support of the Liver in Hepatic Arterial Ligation with Hepatectomy-

Satoshi Takeyama

Second Department of Surgery, Hokkaido University, School of Meidicine

The effect of arterio-portal shunt was studied under the condition of 40% hepatectomy and dearterialization. Eighteen mongrel dogs were divided into three groups. Hepatic arterial ligation with hepatectomy was carried out in the first group (HAL), ligation of the hepatic artery with hepatectomy followed by arterio-portal shunt was performed in the second group (APS), and simple hepatic resection was done in the third group (CON). In spite of hepatic arterial ligation, total hepatic blood flow per unit liver weight was relatively maintained, even in the HAL group, due to a 40% reduction in liver mass. In the HAL group, hepatic oxygen consumption after dearterialization significantly decreased to 72%, and the oxygen extraction ratio declined similarly. The biochemical data and histopathological findings of the APS group were almost the same as the CON group. In the HAL group, however, severe liver dysfunction diagnosed with biochemical parameters and marked ischemic changes under the light microscope were observed. AgNOR (a sign of liver regeneration) demonstrated a satisfactory reaction in th APS group, as well as the CON group, but was significantly inhibited in the HAL group. In conclusion, even if adequate portal blood flow per liver weight were preserved, liver insufficiency is inevitable because of the oxygen uptake decline in liver tissue, due to the low oxygen content of the portal blood. This investigation suggests, therefore, that preserving adequate liver tissue oxygen content is a vital component of liver support.

Key words
arterio-portal shunt, oxygen metabolism of the liver, histopathological findings, argyrcphilic nucleolar organizer regions

Reprint requests
Satoshi Takeyama The Second Department of Surgery, Hokkaido Univeristy School of Medicine
N-14 W-5 Kitaku, Sapporo, 060 JAPAN

Accepted
July 5, 1995

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