J.Jpn. Surg. Soc.. 58(1): 51-70, 1957
STUDIES ON LIVER FUNCTION AND ITS HISTOPATHOLOGY IN SURGERY FOR PORTAL HYPERTENSION
Ⅲ. CLINICAL INVESTIGATION ON LIVER FUNCTION AND HISTOPATHOLOGY FOLLOWING THE SEVERAL SURGICAL PROCEDURES FOR PORTAL HYPERTENSION
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2nd Surgical Department, Tokyo University School of Medicine Mitsuo SUGIURA |
In the group of splenectomy only no demonstrable changes of the liver are noticed in the comparison of preoperative and postoperative biopsy. Long term follow up, however, reveals rather improved function of the liver in most of the cases.
From the data obtained two years after the splenorenal venous shunt and the superior mesenteric caval shunt were performed there is no evidence of remarkable improvement of liver function. One should notice that the occurrence of the postoperative esophageal bleeding are frequent in these groups.
Partial venovenous anastomosis shunting blood side-to-side from portal vein to inferior vena cava resulted in reduction of liver function and marked histopathological changes subsequently which are similar to that of Eck's operation.
The group with arterialization of portal vein presents rather encouraging result in liver function in long term follow up, as compares to the increased impairment by Ede's fistualization. But it is felt that techincal difficulties in this procedure cannot be denied.
Regarding the intrahepatic omentopexy postoperative course are essentially uneventful and follow up one year after the surgery revealed marked improvement of liver function.
one of two patients who were operated on with intrahepatic arterial implantation, one died of pulmonary edema at the third postoperative day and the other did well after the surgery which was believed to result in success-fully connecting the implanted artery with the hepatic vessels perfusing liver parenchyma. Improvement of liver function was seen on the seven weaks follow up of this patient.
From the experimental stand point of view which was confirmed by the encouraging result as shown in Chapter I. and II. the author believes that this intrahepatic arterial implantation is the splendid method for arterialization of the liver after Eck's operation and also more simple procedure than any others of arterilaization of portal vein by vascular anastomosis.
(author's abstruct)
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