J.Jpn. Surg. Soc.. 91(5): 631-638, 1990
Original article
COLLATERAL CIRCULATION AFTER DIVISION OF THE COMMON HEPATIC ARTERY
―CLINICAL STUDY CONCERNING Appleby's OPERATION―
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The Second Department of Surgery, School of Medicine, University of Tokyo, Tokyo, Japan Ichiro Iizuka |
PHA blood flow was 280±225ml/min before CHA occlusion, and after the occlusion it was 170± 132ml/min, or 64±15% of the pre-occlusion flow (n=16). The pulsation of PHA after CHA occlusion was palpable in all cases, and there were no complications due to ischemia in 17 cases which underwent Appleby's operation.
These results suggested that there was fairly good blood flow in PHA maintained by collaterals after CHA occlusion and that, clear pulsation of PHA could be regarded as evidence of suflicient blood flow.
Tissue blood flow (TBF) measurement for the liver and gall-bladder by H2 gas clearance method was also done in several cases of Appleby's operation and of other abdominal operations.
TBF of the gallbladder was significantly lower in cases of Appleby's operation on the day of operation (p<0.02), but the difference between the two operation groups was not recognized 5 days after surgery, suggesting rather quick recovery of circulation. As to hepatic TBF, significant decrease following Appleby's operation could not be proved.
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