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Impact of mesocaval shunt on safe minimal liver remnant:Porcine model

World Journal of Gastroenterology 2013年第31期19卷 5076-5084页

作者： Yu-Liang Tu Xuan Wang Da-Dong Wang Zi-Man Zhu Jing-Wang Tan Department of Hepatobiliary Surgery the First Affiliated Hospital Chinese PLA General Hospital Department of Hepatobiliary Surgery Chinese PLA No. 81 Hospital

AIM: To investigate the capacity of shunts to relieve portal hypertension and decrease the safe minimal liver remnant in ***: A subtotal hepatectomy with < 60 mL blood loss and without hepatic pedicle occlusion was **... 详细信息

AIM: To investigate the capacity of shunts to relieve portal hypertension and decrease the safe minimal liver remnant in ***: A subtotal hepatectomy with mesocaval shunt(MCS) constructed using the prepared left renal vein with an end-to-side running suture of 5-0 *** 21 animals that underwent subtotal hepatectomy and/or MCS were divided into three *** the 15% group,the residual volume was 14%-19% of total liver volume(TLV);in the 15%+ S group,the residual volume was also 14%-19% of TLV with a mesocaval shunt(MCS);and in the 10%+ S group,the residual volume was 8%-13% of TLV with an *** the three groups,the intraoperative portal vein pressure(PVP) and portal vein flow(PVF) were monitored and compared at laparotomy and 1 h *** survival rate,sinusoidal endothelial damage,tissue analysis,and serum analysis were investigated among the three ***: The percentage residual liver volume was 15.9%,16.1% and 11.8% in the 15%,15%+ S,10%+ S groups,*** hepatectomy,PVF and portal-to-arterial flow ratio in the 15%+ S group significantly decreased and hepatic artery flow(HAF) per unit volume significantly increased,compared to those in the 15% *** PVP in the 15%+ S group and 10%+ S group increased slightly from that measured at laparotomy;however,in the 15% group,the PVP increased immediately and significantly above that observed in the other two *** 14-d survival rates were 28.5%,85.6%,and 14.2% in the 15%,15%+ S,and 10%+ S groups,*** the 15%+ S group,the shunts effectively attenuated injury to the sinusoidal endothelium,and the changes in the serum and tissue analysis results were significantly reduced compared to those in the 15% and 10%+ S ***: MCS can decompress the portal vein and so attenuate liver injury from hyperperfusion,and make extreme or margin

关键词： Hepatectomy Safe minimal remnant volume mesocaval shunt Pigs

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Splenocaval versus mesocaval shunt with artificial vascular graft for the treatment of Budd-Chiari syndrome

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Hepatobiliary & Pancreatic Diseases International 2005年第1期4卷 68-70页

作者： Xiao-Wei Dang Pei-Qin Xu Xiu-Xian Ma Deparment of General Surgery First Affiliated Hospital Zhengzhou University Zhengzhou 450052 China. dangxw1001@***

BACKGROUND:Budd-Chiari syndrome (B-CS) is a disease with a poor prognosis, and the results of medication are not satisfactory. Surgical treatments are widely used to depress portal hypertension and hypertension of the inferior vena cava. Splenocaval shunt is usually applied to treat intrahepatic portal hypertension, but we used this method to treat patients with B-CS successfully.METHODS:The clinical data of 72 B-CS patients (type II), including 26 patients treated with splenocaval shunt (splenocaval group) and 46 patients with mesocaval C-shape shunt (mesocaval group) were analyzed retrospectively.RESULTS:The platelet count of the splenocaval group increased significantly after operation (P0.05). Twenty patients in the splenocaval group and 36 in the mesocaval group were followed up for 6 months to 3.5 years, showing the effective rates of 90.0% and 91.7% respectively in the two groups. The occurrence of hepatic encephalopathy was 5.0% and 5.6% respectively in both groups, but there was no recurrent hemorrhage.CONCLUSIONS:Splenocaval shunt can effectively control B-CS, decrease FPP, prevent upper gastrointestinal hemorrhage, and eradicate hypersplenia. Its efficacy is similar to that of mesocaval shunt in treatment of B-CS.

关键词： hepatic veins thrombosis splenocaval shunt mesocaval shunt

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STUDIES OF EFFECTS OF PORTASYSTEMIC SHUNT ON THE FUNCTION OF HEPATIC AND PANCREATIC ISLET CELLS

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Medical Bulletin of Shanghai Jiaotong University 1991年第1期14卷 6-13页

作者：邝耀麟陈治平吴志勇黄安袁济民陈聿修曾民德萧树东 Department of Surgery Renji HospitalSSMUShanghai Shanghai Institute of Digestive Disease SSMUShanghai

The present study was aimed at dynamic observation of the ef fects of end to side portacaval shunt (PCS) and end to side mesocaval shunt (MCS) in dogs on the functions of the liver and pancreatic islet cells. According to correlation between the changes of plasma insulin level in the portal vein and hepatic flow and liver morphology after PCS and MCS, we conclude that the depletion of hepatic flow is the major factor in the deterioration of liver functions. The levels of insulin and glucagon in both the peripheral vein and the portal vein were decreased after PCS and MCS. There was also depletion of pancreatic islet A and B cells and vacuolar degeneration of the pancreas. These changes were more signifcant in PCS than in MCS, suggesting that portasystemic shunt, especially total portasystemie shunt, might damage pancreatic endocrine functions.

关键词： end to side portacaval shunt end to side mesocaval shunt hepatic flow insulin glucagon pancreatic islet Cells

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