J.Jpn. Surg. Soc.. 88(10): 1457-1465, 1987
Original article
AN EXPERIMENTAL STUDY ON THE PATHOPHYSIOLOGY OF STENOSIS AND OCCLUSION IN PORTAL VEIN RECONSTRUCTION IN RESECTION OF CANCER OF THE HEPATIC HILUS
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Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan Naomi Kayo, Shukichi Sakaguchi, Satoshi Nakamura |
All the animals underwent partial (53%) hepatectomy. They were arbitrarily divided into three groups: Non-stenosis Group I with hepatectomy only, Stenosis Group II with partial 70%) stenosis of the portal vein, and Occlusin Group III with ligation of the portal vein. All cases of Group III died within about 122 minutes. The blood flow and pressure of the portal vein, portography, ICG Rmax and the residualli verw eight were serially examined until the fourth week following the operation in Group I and Group II.
Two principal results were derived : 1) In Group I, portal circulation was sufficiently restored and the residual liver showed adequate regeneration. 2) In Group II, hepatofugalc ollateral vessels developed. However, the portal pressure remained significantly high ( p＜0.002) and, the portal blood flow and livert issue blood flow were markedly reduced (p＜0.001) for 1 week after operation. The residual liver weight and liver function (ICG Rmax) were significantly decreased even in the fourth week.
Recently, portal vein resection accompanied with hepatectomy has been accepted as a procedure for advanced carcinoma of the hepatic hilus. This study suggests that stenosis or occlusion of the portal vein should be avoided in the procedure.
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