[
Abstract]
[
Full Text PDF] （in Japanese / 857KB）
[Members Only And Two Factor Auth.] J.Jpn. Surg. Soc.. 94(4): 366-375, 1993
Original article
THE EFFECTIVENESS OF PRESERVATION OF HEPATIC ARTERIAL BLOOD FLOW BY MODIFIED APPLEBY PROCEDURE WITH RECONSTRUCTION OF THE HEPATIC ARTERY ―SERIAL CHANGE OF POSTOPERATIVE LIVER FUNCTION―
We investigated whether modified Appleby procedure with reconstruction of the hepatic artery can avoid complications due to a decrease in heptic arterial flow which has been comprehended in conventional Appleby's operation. The postoperative liver function of 17 patients undergoing modified Appleby's procedure was compared with that of 16 patients undergoing total gastrectomy and distal pancreato-splenectomy (control group). (1) Anticoagulant therapy was not required during and after operation. The common hepatic arterial flow after vascular anastomosis was 396±101ml/min. Postoperative celiac arteriography revealed good patency of anastomosis. (2)There were no significant differences between the modified Appleby group and the control group in any of the blood levels of GOT, GPT total bilirubin and alkaline phosphatase at any point until the fourth postoperative week. In none of the patients in the modified Appleby group, the blood levels of GOT and GPT exceeded 250IU/l. (3)In the modified Appleby group, ICG-R
15 was 4±1% before operation and 6±3% at the first postoperative month.
These results suggested that modified Appleby procedure enabled us to perform resection according to Appleby's operation safely, without need for preoperative or intraoperative examination about the retrograde blood flow mediated by the gastrodudenal artery.
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