Background: Ligation of a branch of the portal vein redirects portal blood to nonligated lobes resulting in lobar hypertrophy. Although the effect of portal vein ligation on liver volume is well documented, the parallel alterations in liver function are still the subject of controversy. Our aim was to assess the time-dependent reactions of regional hepatic function to portal vein ligation by selective biliary drainage.
Methods: Male Wistar rats (n = 44) underwent 80% portal vein ligation. Before the operation as well as 1, 2, 3, 5, and 7 d after circulation, morphology and function (laboratory blood test; hepatic bile flow; plasma disappearance rate of indocyanine green; and biliary indocyanine green excretion) of the liver were examined.
Results: Although portal vein ligation affected liver circulation and morphology to a great extent, serum albumin levels, bilirubin levels, and total hepatic bile flow did not change significantly after the operation. Nevertheless, plasma disappearance rate and biliary indocyanine green excretion indicated a temporary impairment of total liver function with the lowest value on the second day and normalization by the fifth day. Bile production and biliary indocyanine green excretion of ligated lobes decreased rapidly after the operation and remained persistently suppressed, whereas the secretory function of nonligated lobes--after a temporary decline--showed a greater increase than the weight of the lobes.
Conclusions: Portal vein ligation induced temporary impairment of total liver function, followed by rapid recovery mainly by reason of increase in the function of nonligated lobes. Functional increase in nonligated lobes was more pronounced than suggested by the degree of volume gain.
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http://dx.doi.org/10.1016/j.jss.2015.04.033 | DOI Listing |
Surg Radiol Anat
January 2025
Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, 286-8520, Chiba, Japan.
Purpose: We present the case of a rare extrahepatic portocaval shunt that resulted in communication of the portal vein and the inferior vena cava (IVC) at the level between two right renal veins that was incidentally diagnosed with contrast-enhanced computed tomography (CECT) in an asymptomatic patient.
Methods: A woman in her sixties with abdominal pain and diarrhea of unclear origin underwent exploratory abdominal CECT.
Results: The CECT incidentally revealed an extrahepatic portocaval shunt, whereby a vessel arising from the portal vein superior to the confluence of the superior mesenteric and splenic veins drained into the posterior aspect of the IVC between two right renal veins.
World J Gastrointest Surg
January 2025
Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410005, Hunan Province, China.
Background: Pancreatic cancer involving the pancreas neck and body often invades the retroperitoneal vessels, making its radical resection challenging. Multimodal treatment strategies, including neoadjuvant therapy, surgery, and postoperative adjuvant therapy, are contributing to a paradigm shift in the treatment of pancreatic cancer. This strategy is also promising in the treatment of pancreatic neck-body cancer.
View Article and Find Full Text PDFWorld J Gastrointest Surg
January 2025
Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
Background: Cirrhotic patients with super-giant hepatocellular carcinoma (HCC) and portal vein invasion generally have a poor prognosis. This paper presents a patient with super-giant HCC and portal vein invasion, who underwent hepatectomy followed by a combination of sorafenib and camrelizumab, resulting in complete remission (CR) for 5 years.
Case Summary: A 40-year-old male with compensated hepatitis B-related cirrhosis was diagnosed with HCC, Barcelona Clinic Liver Cancer stage C.
Cureus
December 2024
General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND.
Portal vein thrombosis (PVT) typically arises in patients with underlying cirrhosis, hepatobiliary malignancies, abdominal inflammatory conditions, or hematologic disorders. However, in non-cirrhotic individuals, PVT is less common and may initially present with minimal symptoms, escalating significantly if it extends to the mesenteric veins. Here, we present the case of a 37-year-old male with combined portal and mesenteric venous thrombosis, manifesting as acute intestinal obstruction.
View Article and Find Full Text PDFAliment Pharmacol Ther
January 2025
Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Background And Aims: Real-world data on the variceal bleeding (VB) risk in patients receiving atezolizumab-bevacizumab (Atezo-Bev) treatment remain limited. This study aimed to assess the risk of VB and identify risk factors in patients with advanced hepatocellular carcinoma (HCC) receiving Atezo-Bev treatment.
Methods: This retrospective study included 640 patients with HCC who underwent endoscopy before Atezo-Bev treatment at two hospitals in Korea.
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