Mousa Atta, H., Mohamed Ibrahim, I., Osman, A., Khalil Ibrahim, A. (2000). TEMPORARY PORTACAVAL SHUNT IMPROVES THE OUTCOME OF CONTINUOUS NORMOTHERMIC LIVER ISCHEMIA. test, 19(4), 296-305. doi: 10.21608/ejsur.2000.378217
Hussein Mousa Atta; Ibrahim Mohamed Ibrahim; Ahmed Osman; Adel Khalil Ibrahim. "TEMPORARY PORTACAVAL SHUNT IMPROVES THE OUTCOME OF CONTINUOUS NORMOTHERMIC LIVER ISCHEMIA". test, 19, 4, 2000, 296-305. doi: 10.21608/ejsur.2000.378217
Mousa Atta, H., Mohamed Ibrahim, I., Osman, A., Khalil Ibrahim, A. (2000). 'TEMPORARY PORTACAVAL SHUNT IMPROVES THE OUTCOME OF CONTINUOUS NORMOTHERMIC LIVER ISCHEMIA', test, 19(4), pp. 296-305. doi: 10.21608/ejsur.2000.378217
Mousa Atta, H., Mohamed Ibrahim, I., Osman, A., Khalil Ibrahim, A. TEMPORARY PORTACAVAL SHUNT IMPROVES THE OUTCOME OF CONTINUOUS NORMOTHERMIC LIVER ISCHEMIA. test, 2000; 19(4): 296-305. doi: 10.21608/ejsur.2000.378217

TEMPORARY PORTACAVAL SHUNT IMPROVES THE OUTCOME OF CONTINUOUS NORMOTHERMIC LIVER ISCHEMIA

The Egyptian Journal of Surgery
Volume 19, Issue 4, October 2000, Pages 296-305    PDF (1.18 M)
Document Type: Original Article
DOI: 10.21608/ejsur.2000.378217
Authors
Hussein Mousa Atta* 1; Ibrahim Mohamed Ibrahim2; Ahmed Osman3; Adel Khalil Ibrahim4
1Department of Surgery, Faculty of Medicine, El-Minia University, El-Minia
2Department of †Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt
3Pathology, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt
4Clinical Pathology, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt
Abstract
Warm liver ischemia is induced whenever hepatic pedicle clamping performed during liver surgery to minimize operative 
blood loss. The contributory role of intestinal congestion and injury, that follows prolonged hepatic pedicle occlusion, in 
aggravating liver ischemic injury and in inducing remote organ injury is underscored. The hepatic pedicles of twelve dogs were continuously interrupted for 90 minutes. In six dogs portacaval shunts were constructed prior to hepatic pedicle 
occlusion. Two dogs in the control group and all dogs in the shunt group survived for 24 hours after reperfusion (p < 0.05). 
Serum ALT concentrations at 1 and 24 h after reperfusion were significantly higher (p <0.001) in the control versus shunt 
group. Significantly more severe histologic injuries were demonstrated in the liver (grade 4 versus grade 1 respectively, p < 0.005) and the intestine (grade 7 versus grade 1 respectively, p < 0.005) of the control versus the shunt group. The lung and kidney showed morphologic features of acute inflammatory injury in the control but not in the shunt group. We conclude that portacaval shunts, by preventing gut congestion and injury, improve tolerance of the liver to prolonged continuous warm ischemia and prevent its systemic effects on distant organs.
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