Early control of short hepatic portal veins in isolated or combined hepatic caudate lobectomy

BACKGROUND:Caudate lobectomy has long been considered technically difficult.This study aimed to elaborate the significance of early control of short hepatic portal veins(SHPVs) in isolated hepatic caudate lobectomy or in hepatic caudate lobectomy combined with major partial hepatectomy,and to describe the anatomical characteristics of SHPVs.METHODS:The data of 117 patients who underwent either isolated or combined caudate lobectomy by the same team of surgeons from 2005 to 2009 were retrospectively analyzed.From 2005 to 2007(group A,n=55),we carried out early control of short hepatic veins(SHVs) only;from 2008 to 2009(group B,n=62),we carried out early control of both SHVs and SHPVs.The two groups were compared to evaluate which surgical procedure was better.A detailed anatomical study was then carried out on the last 25 consecutive patients in group B to study the number and distribution of SHPVs during surgery.RESULTS:Patients in group B had less intra-operative blood loss,less impairment of liver function,shorter postoperative hospital stay,fewer postoperative complications and required less blood transfusion(P<0.05).The number of SHPVs in the 25 patients was 183,with 7.3±2.7 per patient.The diameters of SHPVs were 1 to 4 mm.On average,3.4 SHPVs/patient came from the left portal vein,2.2 from the bifurcation,1.4 from the right portal vein,and 0.3 from the main portal vein.On average,3.3 SHPVs/patient supplied segment I of the liver,0.4 for segment II,2.1 for segment IV,1.4 for segment V and 0.1 for segment VI.CONCLUSION:Early control of SHPVs in isolated or combined hepatic caudate lobectomy may be a useful method to decrease surgical risk and improve postoperative recovery.

Comparison of Morphology and Microstructural Components of Hepatic Portal Vein between Human and Pig

Summary： In order to provide morphological data and theoretical basis for pig-to-human hepatic xenotransplantation, the difference in morphological parameters and vessel wall structural factors between human and porcine hepatic portal vein was studied. From human subjects and pigs of varying ages, hepatic portal veins were collected, paraffin-embedded and cut into sections. The histological structures were stained with HE, and elastin, collagen and smooth muscles were stained with Weigert, Aniline blue and orange G, respectively. Morphological parameters and relative contents of structural components were determined under microscopy and by computer image analysis system, respectively. The results showed that histological structures of human and porcine hepatic portal vein wall were similar. Caliber, wall thickness, lumen and wall area in pigs increased with age, all in linear correlation to months. Morphological parameters of 6-month-old pigs were similar to those of human. In pigs, collagen content increased gradually with months, elastin content remained relatively stable, smooth muscle content reached the peak at the 3rd month, and collagen/elastin （C/E） rose gradually. The contents of collagen and elastin in porcine hepatic portal vein wall were lower, while the content of smooth muscle was higher than in human, and C/E at the 5th and 6th month was similar to that in human. It is concluded that morphological parameters and contents of structural components of porcine hepatic portal vein vary with age. At the 6 month, its caliber, wall thickness, lumen and wall area are similar to those of human. There are differences in contents of structural components between human and pigs. However, in terms of C/E, mechanic properties of pigs at the 5th and 6th month mimic those of human, hence inosculation is viable in xenotransplantation between pigs and human.

Simultaneous Determination of Pinoresinol Di-gluco-pyranoside and Pinoresinol Glucoside in Rat Plasma by HPLC-tandem MS/MS for Pharmacokinetic Study

Objective Pinoresinol di-glucopyranoside（PDG） is one of the main active lignans of Eucommiae Cortex considered to be a high-quality antihypertensive drug. In this study the pharmacokinetic process of PDG and its primary in vivo metabolite pinoresinol glucoside（PG） in the portal and jugular vein were surveyed and evaluated simultaneously. Methods A sensitive high-performance liquid chromatography coupled with tandem quadruple mass spectrometry（HPLC-MS/MS） method and sample preparation protocol were developed and validated in method of selectivity, sensitivity, precision, stability, and extraction recovery for the simultaneous determination of PDG and its primary metabolite PG in rat plasma. The double intubation technique was used to simultaneously collect blood from common jugular vein and hepatic portal vein after single ig administration of PDG. Results Using this method, the quantification linearity ranges of PDG and PG in rat plasma were both 0.05-100 ng/mL. This method was successfully applied to the evaluation of the absolute oral bioavailability of PDG and determination of the pharmacokinetic properties of PDG and PG after ig administration of single dose in rats. The bioavailability of PDG at common jugular vein was 51.3% compared to that of 91.6% at hepatic portal vein. Conclusion We conclude that liver is the major conversion site of PDG to PG.