New Surgical Technique for Portal Venous Port System in Swine

Kaiser, Gernot M.; Frühauf, Nils R.; Broelsch, Christoph E.

doi:10.1159/000089241

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…They developed a technique in which the portal venous catheter was introduced into the mesenteric vein of the ileocecal junction. Recently Kaiser et al published a series of portal venous catheters inserted through the pancreatic vein into the portal vein within the hepatoduodenal ligament [44]. Our technique is similar to the procedure published by Van Leuwen [45] including vascular clamping of the portal vein prior to incision and fixation of the catheter by suturing.…”

Section: Discussionmentioning

confidence: 99%

Porcine model for the study of liver regeneration enhanced by non-invasive 13C-methacetin breath test (LiMAx test) and permanent portal venous access

et al. 2019

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Introduction Despite advances in perioperative management and surgical technique, postoperative liver failure remains a feared complication after hepatic resection. Various supportive treatment options are under current discussion, but lack of structured evaluation. We therefore established a porcine model of major liver resection to study regeneration after partial hepatectomy in a reliable and well-defined pre-clinical setting. Methods Major hepatectomy was performed on seven minipigs with the intention to set up a non-lethal but relevant transient impairment of liver function. For steady postoperative vascular access (e.g. for blood withdrawal, measurement of venous pressure), permanent catheters were implanted into the internal jugular and portal veins, respectively. Animals were followed up for 30 days; clinical and laboratory results were recorded in detail. Monitoring was enhanced by non-invasive determination of the maximum liver function capacity (LiMAx test). Results and conclusions The established porcine model appeared suitable for evaluation of postoperative liver regeneration. Clinical characteristics and progression of liver function impairment as well as subsequent recovery were comparable to courses known from surgery in humans. Laboratory parameters (e.g. liver enzymes, bilirubin, INR, coagulation factor II) showed relevant derangements during postoperative days (POD) 0 to 3 followed by normalization until POD 7. Application of the LiMAx test was feasible in minipigs, again showing values comparable to humans and kinetics in line with obtained laboratory parameters. The exteriorized portal vein catheters enabled intra- and postoperative monitoring of portal venous pressures as well as easy access for blood withdrawal without relevant risk of postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Porcine model for the study of liver regeneration enhanced by non-invasive 13C-methacetin breath test (LiMAx test) and permanent portal venous access

et al. 2019

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“…Experimental procedures in pigs frequently require access to blood vessels, such as hepatic vein (Farias et al 1986), portal vein (Kaiser et al 2005), external jugular vein Lombardo et al 2010), internal carotid artery (Nsadi et al 2011), common iliac artery (Fearn et al 2006), femoral vein (Pinkernelle et al 2009), cranial vena cava (Damm et al 2000), and pulmonary artery (Holmes and Weiskopf 1990). Multiple abdominal intravascular catheterization in pigs is also a common surgical procedure and an important research tool in animal nutrition (Bajjalieh et al 1981;Olesen et al 1989;Stoll et al 1998;Yen et al 2004;Hooda et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Minimally-invasive catheterization of portal and mesenteric veins and abdominal aorta for quantitative determination of portal-drained viscera metabolism in pigs

Zhang

Wang²,

Tong³

et al. 2016

Can. J. Anim. Sci.

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A laparoscopic catheterization of portal and ileal veins as well as abdominal aorta was performed in eight pigs under general anesthesia for quantitative determination of portal-drained viscera metabolism. Three polyurethane catheters were introduced into the target vessels through an abdominal wall cannula using the guide catheter and wire. Surgery duration, length of incisions, and postoperative outcomes were recorded. On days 7 and 30, portal vein blood flow rates were measured by paraaminohippuric acid method. On day 35, a second laparoscopy was performed to monitor the setup of intraabdominal catheters. The laparoscopic procedures were completed with a mean operative time of 82 ± 9 min, and mean total incision size was 4.5 ± 0.5 cm. No major intraoperative or postoperative complications were encountered. The second laparoscopy showed that position and fixation of catheters remain stable 35 d after the surgical preparation. Portal vein blood flow remained similar (P > 0.05) from 7 to 30 d after the laparoscopic surgical procedure. Retention of catheters in six pigs was more than 60 d, and the other two were 42 and 56 d. We conclude that this novel technique is an attractive alternative to traditional surgical catheterization procedures.Key words: laparoscopy, multiple endovascular catheterization, technique, pig.Résumé : Un cathétérisme laparoscopique des veines portes et iléales ainsi que de l'aorte abdominale a été effectuée chez huit porcs sous anesthésie générale pour la détermination quantitative du métabolisme des viscères drainés par la veine porte. Trois cathéters en polyuréthane ont été introduits dans les vaisseaux sanguins cibles par une canule dans la paroi abdominale en utilisant un cathéter guide et un fil. La durée de chirurgie, la longueur des incisions ainsi que les résultats postopératoires ont été enregistrés. Au jours 7 et 30, les débits de sang dans la veine porte ont été mesurés par la méthode de l'acide para-aminohippurique (PAH). Au jour 35, une deuxième laparoscopie a été effectuée pour surveiller l'installation des cathéters intra-abdominaux. Les procédures laparoscopiques ont été terminées avec un temps moyen d'opération de 82 ± 9 min et la longueur moyenne totale de l'incision était de 4,5 ± 0,5 cm. Aucune complication majeure pendant ou après opération n'ont été rencontrées. La deuxième laparoscopie a montré que la position et la fixation des cathéters demeuraient stables 35 jours après la préparation chirurgicale. Les débits de sang dans la veine porte demeurent similaires (P > 0,05) des jours 7 à 30 après la chirurgie laparoscopique. La rétention des cathéters dans six des porcs a été de plus de 60 jours tandis qu'elle était de 42 et 56 chez les deux autres. Nous concluons donc que cette nouvelle technique est une alternative attrayante aux procédures traditionnelles chirurgicales de cathétérisme. [Traduit par la Rédaction] Mots-clés : laparoscopie, cathétérisme endo-vasculaire multiple, technique, porc.

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“…Animal models serve as an important research tool for nutritional physiological studies, in which swine are commonly used owing to the numerous anatomical and physiological similarities between porcine and human [ 14 ]. Traditionally, portal vein sampling in swine involved a surgical procedure including an abdominal incision and placement of a vascular access port for repeated sampling [ 15 , 16 ]. Herein, we describe two different percutaneous techniques to perform blood sampling from the portal and splenic veins and compare the temporal sequence of insulin and zinc release after a glucose challenge in each technique.…”

Section: Introductionmentioning

confidence: 99%

Comparative Evaluation of Two Venous Sampling Techniques for the Assessment of Pancreatic Insulin and Zinc Release upon Glucose Challenge

Pillai

Silvers

Christensen

et al. 2015

Journal of Diabetes Research

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Advances in noninvasive imaging modalities have provided opportunities to study β cell function through imaging zinc release from insulin secreting β cells. Understanding the temporal secretory pattern of insulin and zinc corelease after a glucose challenge is essential for proper timing of administration of zinc sensing probes. Portal venous sampling is an essential part of pharmacological and nutritional studies in animal models. The purpose of this study was to compare two different percutaneous image-guided techniques: transhepatic ultrasound guided portal vein access and transsplenic fluoroscopy guided splenic vein access for ease of access, safety, and evaluation of temporal kinetics of insulin and zinc release into the venous effluent from the pancreas. Both techniques were safe, reproducible, and easy to perform. The mean time required to obtain desired catheter position for venous sampling was 15 minutes shorter using the transsplenic technique. A clear biphasic insulin release profile was observed in both techniques. Statistically higher insulin concentration but similar zinc release after a glucose challenge was observed from splenic vein samples, as compared to the ones from the portal vein. To our knowledge, this is the first report of percutaneous methods to assess zinc release kinetics from the porcine pancreas.

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New Surgical Technique for Portal Venous Port System in Swine

Cited by 6 publications

References 20 publications

Porcine model for the study of liver regeneration enhanced by non-invasive 13C-methacetin breath test (LiMAx test) and permanent portal venous access

Porcine model for the study of liver regeneration enhanced by non-invasive 13C-methacetin breath test (LiMAx test) and permanent portal venous access

Minimally-invasive catheterization of portal and mesenteric veins and abdominal aorta for quantitative determination of portal-drained viscera metabolism in pigs

Comparative Evaluation of Two Venous Sampling Techniques for the Assessment of Pancreatic Insulin and Zinc Release upon Glucose Challenge

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