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肝動脈遮断および40%肝切除モデルにおける門脈部分動脈化術の有用性に関する実験的検討
| Title: | 肝動脈遮断および40%肝切除モデルにおける門脈部分動脈化術の有用性に関する実験的検討 |
| Other Titles: | Usefulness of Arterio-Portal Shunt on 40% Hepatectomized and Hepatic Artery Occluded Model |
| Authors: | 真名瀬, 博人1 Browse this author |
| Authors(alt): | Manase, Hiroto1 |
| Issue Date: | 30-Sep-1998 |
| Publisher: | Hokkaido University |
| Abstract: | We performed an experimental study in dogs with 40% hepatectomy to prove the efficacy and safety of arterioportal shunt(APS). 42 adult mongrel dogs were used for the experiments. After dearterialization of all the collateral arteries to the liver, the dogs were divided into 3 groups. In Group 1, dearterialization of the hepatie artery, 40% hepatectomy and APS were performed; in Group 2, only 40% hepatectomy was performed, and in Group 3, dearterialization of the hepatic artery and 40% hepatectomy were perforrned, respectively. APS was constructed by anastomosing the common hepatic artery with the portal vein. The hepatic hemodynamics, oxygen delivery and consumption were evaluated, and bioehemical and histological studies were carried out in each group. The study consisted of a short-term (48-hour; Experiment 1) and a medium-term (4-weeks; Experiment 2) observations. In Experiment 2, liver regeneration was additionally examined. In Experiment 1, Group 1 and 2 presented nearly same findings in all the 4 examination points. However, in Group 3, postoperative oxygen delivery and consumption significantly decreased, and biochemical and histological examinations evidenced the significant liver failure. These results show that APS is capable of preventing postoperative liver failure during the short-term observation period and can substitute for reconstruction of hepatic artery. Experiment 2 was intended for a longer follow-up of Experirnent 1. Howeverr Group 3 did not survive longer than 1 week, and was thus excluded. As a result, in Group 1 and 2, the 4 examination points remained alike for p.o. 4 weeks. And, both groups regained the preoperative liver weight, respectively, at p.o. 4 weeks. The number of PCNA (proliferating cell nuclear antigen) positive hepatocytes significantly increased at p.o. 1 week in both groups. These findings revealed that regeneration of the liver in Group 1 with APS was equivalent to that in Group 2 with mere hepatectomy for p.o. 4 weeks at least. These results indicate that liver failure can be averted by constructing APS in hepatectorny cases where reconstruction of hepatic artery is impossible. |
| Description: | 短縮題名: 肝切除下門脈部分動脈化術の有用性 |
| Conffering University: | 北海道大学 |
| Degree Report Number: | 甲第4546号 |
| Degree Level: | 博士 |
| Degree Discipline: | 医学 |
| Type: | theses (doctoral) |
| URI: | http://hdl.handle.net/2115/51563 |
| Appears in Collections: | 学位論文 (Theses) > 博士 （医学）
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Submitter: 真名瀬 博人
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