Resection of the portal vein in the treatment of perihilar cholangiocarcinoma

Kotenko, O G; Popov, A O; Grinenko, A V; Gusev, A.V.; Федоров, Д. А.; Коршак, А А; Ostapishen, Oleksander; Minich, A.A.

doi:10.22141/1997-2938.4.35.2017.118888

Cited by 1 publication

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“…Mucous membrane of the jejunum is full-blooded, edematous, with single cells of point hemorrhages. The above described evidence of post-resection portal hypertension [3,8,22]. The resulting morphometric parameters of the vessels of the microhemocirculatory duct of experimental animals are shown in Table 1.…”

Section: Resultsmentioning

confidence: 91%

Morphometric Analysis Remodeling Vessels Hemomicrocirculatory Bed of Jejunum at Resections of Liver

Hnatjuk

Татарчук

2018

Rep. of Morph.

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Liver resection is widely used in modern surgical departments. Removal of large volumes of the liver leads to postresection portal hypertension, which is complicated by bleeding from varicose veins of the esophagus, stomach, rectum, ascites, splenomegaly with secondary hypersplenism, parenchymal jaundice and portosystemic encephalopathy. The widespread prevalence of this pathology, high mortality from its complications indicates that it is an important medical and social problem. The aim of the study is quantitative morphological study of the features of remodeling the vessels of the hemomicrocirculatory bad of the jejunum at resection of different volumes of the liver. The studies were conducted on 45 sexually mature male rats, which were divided into 3 groups. The first group consisted of 15 intact virtually animals, 2-15 rats after resection of the left lateral part – 31.5% of the parenchyma of the liver, 3-15 animals after resection of the right and left lateral parts of the liver (58.1%). Euthanasia of experimental animals was carried out by bloodletting in conditions of thiopental anesthesia 1 month after the beginning of the experiment. The hemomicrocirculatory bad of the jejunum was studied by injection of its vessels into the carcass-gelatinous mixture, which was injected through the abdominal aorta. From the jejunum, lightened and histologic preparates were prepared and morphometrically studied the vessels of the microhemocirculatory bed. Quantitative indicators were processed statistically, the difference between the comparative values was determined by the Student's criterion. It was established that the severity of structural transformation of the vessels of the microhemocirculatory bad of the jejunum depends on the volume of the removed parenchyma of the liver. The analysis of the obtained results revealed that one month after resection of 31.5% of liver parenchyma, the morphometric parameters of the vessels of the haemomicrocirculatory bad of the jejunum were insignificantly altered. It was determined that resection of 58.1% of liver parenchyma caused postresection portal hypertension and marked remodeling of blood vessels of the hemomicrocirculatory bad of the jejunum, which was characterized by narrowing of arterioles by 23.4%, precapillary arterioles by 22.8%, hemocapillaries by 22.9%%, decrease in the density of microvessels – by 22.4%, the expansion of the capillary venules – by 35.5% and venules – by 28.7%, venous plethora, hypoxia, dystrophy, necrobiosis of cells and tissues, infiltrative processes and sclerosis. Resection of 58.1% of liver parenchyma leads to postresection portal hypertension, pronounced narrowing of lumen of the vessels of the adnexa and exchange units hemomicrocirculatory bed, expansion of the postcapillary venules and venules, venous plethora, hypoxia, dystrophy and necrobiosis of cells and tissues, infiltrative and sclerotic processes in wall of the jejunum.

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Section: Resultsmentioning

confidence: 91%