The effect of hepatic ischaemia on liver function and the restoration of liver mass after 70 per cent partial hepatectomy in the dog

Abstract

Partial hepatectomy was performed in dogs either as the only procedure or following a period of ischaemia of liver remnant produced by inflow occlusion for periods of 30-60 minutes before partial hepatectomy. Temporary portal decompression was maintained through the portion of liver subsequently excised. 1. Survival in dogs subjected to partial hepatectomy and ischaemia to the liver remnant was similar to that in animals after partial hepatectomy alone. 2. Metabolic changes were similar in both groups but dogs submitted to partial hepatectomy and ischaemia to the remnant had higher serum alkaline phosphatase and alanine amino-transferase levels with increased bromsulphthalein in the fourth to sixth post-operative weeks. 3. Replacement of liver mass proceeded rapidly in all groups of animals. It is concluded that ischaemia of the liver remnant for up to 60 minutes preceding partial hepatectomy in the dog is consistent with survival and produced little change in postoperative liver function or in the rate of restoration of liver mass.

LIVER RESTORATlON POLLOWlNG PARTIAL BEPATBCTOMY AND CIIOLECYSTlLOBECTOMY IN DOG

“…There results were supported by other researehers (4,12,13,17,18) who conduded that the regeneration response was influenced by the amount of liver removed at operation. The present~;tudyconduded that there was no significant differences in regeneration percentage between partial hepatectomy and corresponding choleeystilobectomy.…”

Effects of the Free Radical Scavenger Dimethyl Sulphoxide on Experimental Normothermic Ischaemia of the Liver

“…Similar effects of ischaemia on hepatic enzymes have been previously noted in experimental studies of intermittent and continuous pedicle clamping [6, 14], although the issue is complicated since other studies have shown that intermittent clamping may be associated with very delayed histological damage to the liver as well as impaired bilirubin excretion [5]. Many of these studies are not strictly comparable, however, since they did not combine hepatectomy with liver inflow occlusion [26]. In a recent study assessing the effects of intermittent versus continuous hepatic inflow occlusion with or without hemihepatectomy in the pig, hepatocellular damage was not detected following 90 min of ischaemia and a prolonged period (120 min) of reperfusion in those animals not undergoing hepatic resection; however, similar increases in serum AST were noted in both the intermittently and continuously clamped groups of animals undergoing hemihepatectomy [27].…”

Anatomical Variations of the Extrahepatic Ducts in Dogs: Knowledge for Surgical Procedures

“…Ligature of the hepatic duct results in icterus and an increase in alkaline phosphatase in dogs [2,6]. The length of the cystic duct estimated in this study was more than 5 mm in most dogs (88%).…”

“…In cholecystectomy, the cystic duct is sufficiently left to prevent ligature on the hepatic duct, which enters the CBD near the entrance of the cystic duct. Ligation of the hepatic ducts results in icterus and elevated levels of alkaline phosphatase [2,6].Anatomical information regarding canine biliary drainage has been reported by Sleight and Thomford [10] and has been cited in recent clinical textbooks [1,8] as well as a journal article [9]. However, this anatomical information requires supplementation to facilitate safe and efficient surgical procedures.…”

“…In cholecystectomy, the cystic duct is sufficiently left to prevent ligature on the hepatic duct, which enters the CBD near the entrance of the cystic duct. Ligation of the hepatic ducts results in icterus and elevated levels of alkaline phosphatase [2,6].…”