Objective: To evaluate the tolerance limit of rats tonormothermic hepatic inflow occlusion under portalblood bypass.Methods: A new rat model of normothermic hepaticinflow occlusion under portal blood bypass was estab-...Objective: To evaluate the tolerance limit of rats tonormothermic hepatic inflow occlusion under portalblood bypass.Methods: A new rat model of normothermic hepaticinflow occlusion under portal blood bypass was estab-lished by clamping temporarily the pedicles of all liverlobes while the caudal lobe was kept as a passage ofthe portal blood flow. After hepatic blood flow re-stored, the caudal lobe was cut off. On the 7th postop-erative day, survival rate, hepatic morphological changes,and the severity and reversibility of the injured energymetabolism of the liver were investigated.Results: All rats that had been subjected to 30, 60 and90 minutes of hepatic inflow occlusion under portalblood bypass survived on the 7th postoperativeday. Ischemia-reperfusion injury of the liver was re-versible and compensatory in rats with hepatic inflowocclusion within 90minutes. However, the survivalrates of rats with 100, 110 and 120 minutes of hepaticinflow occlusion were 50%, 30% and 20% respective-ly. Liver injury of rats with 120 minutes of hepatic in-flow occlusion was severe and irreversible.Conclusions: The tolerance limit of rats to normother-mic hepatic inflow occlusion is enhanced significantlyunder portal blood bypass and the upper limit is 90minutes.展开更多
AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were ...AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were divided into 3 groups based on the technique used for achieving hepatic vascular occlusion:group 1,vascular occlusion was achieved by the Pringle maneuver (n=20);group 2,by hemihepatic vascular occlusion (HVO) (n=20);and group 3,by BIOwHAC (n=19).We compared the procedures among the three groups in term of operation time,intraoperative bleeding,postoperative liver function,postoperative complications,and length of hospital stay.RESULTS:There were no statistically significant differences (P > 0.05) in age,sex,pathological diagnosis,preoperative Child's disease grade,hepatic function,and tumor size among the three groups.No intraoperative complications or deaths occurrred,and there were no significant intergroup differences (P > 0.05) in intraoperative bleeding,hepatic function change 3 and 7 d after operation,the incidence of complications,and length of hospital stay.BIOwHAC and Pringle maneuver required a significantly shorter operation time than HVO;the difference in the serum alanine aminotransferase or aspartate aminotransferase levels before and 1 d after operation was more significant in the BIOwHAC and HVO groups than in the Pringle maneuver group (P < 0.05).CONCLUSION:BIOwHAC is convenient and safe;this technique causes slight hepatic ischemia-reperfusion injury similar to HVO.展开更多
文摘Objective: To evaluate the tolerance limit of rats tonormothermic hepatic inflow occlusion under portalblood bypass.Methods: A new rat model of normothermic hepaticinflow occlusion under portal blood bypass was estab-lished by clamping temporarily the pedicles of all liverlobes while the caudal lobe was kept as a passage ofthe portal blood flow. After hepatic blood flow re-stored, the caudal lobe was cut off. On the 7th postop-erative day, survival rate, hepatic morphological changes,and the severity and reversibility of the injured energymetabolism of the liver were investigated.Results: All rats that had been subjected to 30, 60 and90 minutes of hepatic inflow occlusion under portalblood bypass survived on the 7th postoperativeday. Ischemia-reperfusion injury of the liver was re-versible and compensatory in rats with hepatic inflowocclusion within 90minutes. However, the survivalrates of rats with 100, 110 and 120 minutes of hepaticinflow occlusion were 50%, 30% and 20% respective-ly. Liver injury of rats with 120 minutes of hepatic in-flow occlusion was severe and irreversible.Conclusions: The tolerance limit of rats to normother-mic hepatic inflow occlusion is enhanced significantlyunder portal blood bypass and the upper limit is 90minutes.
基金Supported by The Inner Mongolia Science Foundation,Grant No.2009BS1103
文摘AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were divided into 3 groups based on the technique used for achieving hepatic vascular occlusion:group 1,vascular occlusion was achieved by the Pringle maneuver (n=20);group 2,by hemihepatic vascular occlusion (HVO) (n=20);and group 3,by BIOwHAC (n=19).We compared the procedures among the three groups in term of operation time,intraoperative bleeding,postoperative liver function,postoperative complications,and length of hospital stay.RESULTS:There were no statistically significant differences (P > 0.05) in age,sex,pathological diagnosis,preoperative Child's disease grade,hepatic function,and tumor size among the three groups.No intraoperative complications or deaths occurrred,and there were no significant intergroup differences (P > 0.05) in intraoperative bleeding,hepatic function change 3 and 7 d after operation,the incidence of complications,and length of hospital stay.BIOwHAC and Pringle maneuver required a significantly shorter operation time than HVO;the difference in the serum alanine aminotransferase or aspartate aminotransferase levels before and 1 d after operation was more significant in the BIOwHAC and HVO groups than in the Pringle maneuver group (P < 0.05).CONCLUSION:BIOwHAC is convenient and safe;this technique causes slight hepatic ischemia-reperfusion injury similar to HVO.
