Document Detail

Jejunectomy can reduce excessively elevated portal pressure after major hepatectomy in beagle dogs.
MedLine Citation:
PMID:  16203015     Owner:  NLM     Status:  MEDLINE    
A number of factors can lead to the life-threatening liver dysfunction in the aftermath of an extended hepatectomy. Prominent among them is the high portal pressure induced by the concentrated flow of the entire stream of portal blood toward the small remnant liver. Twelve beagle dogs were randomly divided into group A (n=6, 70% hepatectomy) and group B (n=6, 70% hepatectomy after jejunectomy). Three dogs in each group were euthanized at 1 or 4 weeks after the operation and examined to evaluate hemodynamic changes, liver functions, and liver histology. One hour after the hepatectomy, the animals in group B exhibited a significantly lower portal pressure (P=0.002) and significantly higher hepatic arterial flow (P=0.004) than the animals in group A. As more time passed, the total hepatic flow and hepatic tissue flow both rose up to levels significantly higher than those in group A (P=0.037 and P=0.025, respectively). The alkaline phosphatase, total protein, albumin, and anti-thrombin III were all significantly better in group B than in group A on the 1st post-operative day. Liver specimens biopsied at 1 h after the hepatectomy showed significantly more swelling of the hepatocytes in group A than in group B. In addition, an immunohistochemical study using the TUNEL method for liver biopsy on the seventh post-operative day revealed numerous positive cells in group A but few in group B. Our results suggest that the portal pressure control by the enterectomy can forestall dysfunction of the remnant liver after extended hepatectomy, especially during the early post-operative period.
Youichi Kawano; Koho Akimaru; Kaiyo Takubo; Koshi Matsumoto; Hiroshi Yoshida; Yasuhiro Mamada; Nobuhiko Taniai; Takashi Tajiri
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Publication Detail:
Type:  Journal Article     Date:  2005-10-03
Journal Detail:
Title:  The Journal of surgical research     Volume:  130     ISSN:  0022-4804     ISO Abbreviation:  J. Surg. Res.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-03     Completed Date:  2006-02-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-33     Citation Subset:  IM    
Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan.
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MeSH Terms
Hepatectomy / adverse effects*
Hypertension, Portal / etiology*,  physiopathology,  surgery*
In Situ Nick-End Labeling
Jejunum / surgery*
Liver / blood supply,  pathology,  surgery
Liver Circulation
Organ Size
Portal Vein / physiology
Postoperative Complications / pathology,  physiopathology,  prevention & control
Venous Pressure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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