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Effect of portal arterialization on hepatic blood flow and ammonia clearance after end to side portacaval shunt

par Lambilliotte, Jean-Pierre ;Pector, Jean Claude ;Verbeustel, Suzanne
Référence Digestion, 9, 4, page (332-342)
Publication Publié, 1973

Article révisé par les pairs

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Résumé :

Total hepatic blood flow (THBF), blood ammonia concentration and ammonia tolerance test were measured in two groups of dogs: group I with end to side portacaval shunt, group II with end to side portacaval shunt and arterialization of the hepatic stump of the portal vein by means of the splenic artery. The results showed that: in group I, THBF decreased more than 50% after shunt, while in group II, THBF remained at preoperative value; hepatic extraction efficiency remained normal in the two groups after the operation; the peripheral blood ammonia level during the ammonia tolerance test was significantly elevated in the shunted animals when compared to the portal arterialized specimens, and moderate signs of perivascular fibrosis were found in the arterialized livers. It is concluded that arterialization of the liver after portacaval shunt could be advisable in some cases where portal blood flow remains important before shunting. The authors point out the importance of proper blood flow and intra hepatic portal pressure to reduce histologic alteration of the liver.