Effects of norepinephrine on blood flow in the common hepatic artery and portal vein following surgical denervation of the celiac trunk in dogs

1992 ◽  
Vol 37 (1) ◽  
pp. 72
Author(s):  
Shuuji Akasaka
2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Ljaljukov ◽  
E Loginova ◽  
G Nechaeva ◽  
I Druk ◽  
A Semenkin ◽  
...  

Abstract Background Abdominal circulation plays the important physiological role for structure and function of the digestive system, maintenance of nutrient homeostasis. Purpose To study the features of abdominal hemodynamics in patients with visceroptosis. Methods We studied 69 patients (mean age 22.28±3.7 years) with splanchnoptosis (visceroptosis) and 52 age- and sex- matched patients without splanchnoptosis (controls). Exclusion criteria: a history of digestive system surgery of taking blood circulation activating drugs. Doppler ultrasonography of the common hepatic artery, splenic artery, superior mesenteric artery, portal vein was performed on an empty stomach and 30 minutes after a food sample (standardized for proteins (14 g), fats (10 g) and carbohydrates (45 g)) using the Sonoace-8000 ultrasound scanner (Medison, South Korea). The data were analyzed using the Statistica-6 packages. Results There were no differences in hemodynamic parameters of fasting abdominal blood flow (ABF). After a food testing, in the postprandial period the ABF in all vessels in patients with splanchnoptosis was lower than in controls: the portal vein blood flow (BF) 1124,0 [1030,0–1419,0] ml/min vs 1373,0 [1136,0–1567,5] ml/min respectively (U=433,5; Z=−2,1; p=0,0342); the common hepatic artery BF 341,0 [295,0–394,0] ml/min vs 412,0 [331,0–521,0] ml/min respectively (U=335,0; Z=−2,3; p=0,0218); the splenic artery BF 396,0 [292,0–538,0] ml/min vs 502,0 [394,0–594,0] ml/min respectively (U=328,0; Z=−2,1; p=0,0399); the superior mesenteric artery BF 988,0 [837,0–1272,0] ml/min vs 1136,5 [992,0–1465,0] ml/min respectively (U=1625,5; Z=−2,2; p=0,0314). Changes in ABF were correlated with splanchnoptosis: the portal vein BF with any ptosis (rs=−0,21; p<0.05), the common hepatic artery BF with gastroptosis (rs=−0,38; p<0.05), the superior mesenteric artery BF with colonoptosis (rs=−0,86; p<0.05). The peripheral vascular resistance was correlated with the common hepatic artery BF (rs=−0,46; p<0.05), with the splenic artery BF (rs=−0,33; p<0.05) and with the superior mesenteric artery BF (rs=−0.79; p<0.05). Conclusions Patients with splanchnoptosis in the postprandial period have low volumetric BF in abdominal aorta vessels. This can be associated with the length of the mesenteric vessels, which undergoes the greatest changes in splanchnoptosis. Food testing reveals latent BF deficit in patients with splanchnoptosis. FUNDunding Acknowledgement Type of funding sources: None.


2010 ◽  
Vol 32 (9) ◽  
pp. 883-885 ◽  
Author(s):  
Mo Jin Wang ◽  
Zhong Cheng ◽  
Rui Wang ◽  
Yuan Li ◽  
Zong Guang Zhou

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Gregory Sergeant ◽  
Erik Schadde ◽  
Geert Maleux ◽  
Raymond Aerts

A 64-year-old female patient with adenocarcinoma of the head of the pancreas with encasement of the common hepatic artery and portal vein stenosis was reexplored after six cycles of gemcitabine (1000 mg/m2). Prior to surgery, the patient underwent balloon dilation and stenting of the portal vein in addition to successful coil embolisation of the common hepatic artery, proper hepatic artery, and proximal gastroduodenal artery. After embolisation, a pylorus-preserving pancreaticoduodenectomy was performed with resection of the common hepatic artery and portal vein confluens. Pathological examination showed a moderately differentiated pT3N0 (Stage IIa, TNM 7th edition) tumor with negative section margins. We show with this case that in selected cases of periampullary cancer with encasement of the common hepatic artery, it is technically feasible to perform pancreaticoduodenectomy with hepatic artery resection and negative surgical margins. Nevertheless, the oncological benefit of extended arterial resections remains controversial.


2019 ◽  
Vol 47 (12) ◽  
pp. 6182-6191
Author(s):  
Wen-wei Liao ◽  
Xiang-chao Ling ◽  
Cheng Zhang ◽  
Fu-rong Liu ◽  
Xiao-feng Zhu ◽  
...  

Objective Because of the complicated blood supply and vascular structure of the pancreas, blood vessel reconstruction and reshaping are generally required during pancreas transplantation. We modified the vascular preparation procedure for the donor pancreas (i.e., no vascular reconstruction was performed) based on experiences in our department and in other domestic and international transplantation centers. Methods Twelve donor pancreas preparations without vascular reconstruction were performed. The patch (Carrel patch), celiac trunk, and superior mesenteric artery were preserved as arterial inflow channels for the donor pancreas. The common hepatic artery and the gastroduodenal artery were transected at a site 0.5 cm away from the bifurcation. The bifurcated portion was preserved for the donor liver. The stumps of the gastroduodenal artery and common hepatic artery were then ligated. The portal vein was transected in the middle of the hepatoduodenal ligament during separation of the liver and pancreas. The partial portal vein preserved with the pancreas was used as the outflow channel of the donor pancreas. Results The transplanted pancreas functioned well in the recipients, and no vascular complications were reported. Conclusion The overall efficacy of pancreas transplantation without vascular reconstruction has been improved.


2016 ◽  
Vol 15 (3) ◽  
pp. 259-262
Author(s):  
Satheesha Nayak Badagabettu ◽  
Ashwini Aithal Padur ◽  
Naveen Kumar ◽  
Deepthinath Reghunathan

Abstract Anatomical variations of the celiac trunk and its branches are particularly important from a surgical perspective due to their relationships with surrounding structures. We report here a particularly rare variant involving absence of the celiac trunk in association with trifurcation of the common hepatic artery. These variations were found in an adult male cadaver. We perform a review of the literature and discuss the clinical and embryological significance of these variations. Recognition of celiac trunk and hepatic artery variations is of utmost importance to surgeons and radiologists because multiple variations can lead to undue complications.


2014 ◽  
Vol 66 (1) ◽  
pp. 233-240 ◽  
Author(s):  
Neda Ognjanovic ◽  
D. Jeremic ◽  
Ivana Zivanovic-Macuzic ◽  
Maja Sazdanovic ◽  
P. Sazdanovic ◽  
...  

The aim of this study was to detect and describe the existence and incidence of anatomical variations of the celiac trunk and superior mesenteric artery. The study was conducted on 150 persons, who underwent abdominal Multi- Detector Computer Tomography (MDCT) angiography, from April 2010 until November 2012. CT images were obtained with a 64-row MDCT scanner in order to analyze the vascular anatomy and anatomical variations of the celiac trunk and superior mesenteric artery. In our study, we found that 78% of patients have a classic anatomy of the celiac trunk and superior mesenteric artery. The most frequent variation was the origin of the common hepatic artery from the superior mesenteric artery (10%). The next variation, according to frequency, was the origin of the left gastric artery direct from the abdominal aorta (4%). The arc of Buhler as an anastomosis between the celiac trunk and superior mesenteric artery, was detected in 3% of cases, as was the presence of a common trunk of the celiac trunk and superior mesenteric artery (in 3% of cases). Separate origin of the splenic artery and the common hepatic artery was present in 2% of patients. The MDCT scanner gives us an insight into normal anatomy and variations of the abdominal blood vessels, which is very important in the planning of surgical interventions, especially transplantation, as well as in the prevention of complications due to ischemia.


2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Francesco Giurazza ◽  
Mattia Silvestre ◽  
Amedeo Cervo ◽  
Franco Maglione

We report on an asymptomatic 56-year-old male with incidental diagnosis of celiac trunk aneurysm, diagnosed during an ultrasound scan performed to control polycystic kidney disease. The CT scan revealed a 3.8 cm saccular aneurysm of the celiac artery dissected in the superior wall with a consequent 4.3 cm pseudoaneurysm; we adopted an endovascular approach to exclude the lesion by catheterizing the celiac trunk and positioning a vascular plug in the common hepatic artery and a covered stent in the splenic artery; finally we fulfilled the aneurysm sac with Onyx. 30-day control CT scan revealed procedural success. Five years later he came back to our department for an aneurysm relapse in the common hepatic artery. We performed a second endovascular approach with a superselective catheterization of the pancreaticoduodenal arcade in order to exclude the lesion with Onyx and microcoils. Nowadays the patient is in good clinical conditions. Endovascular approach is a valuable method to treat visceral aneurysms; however, long-term imaging follow-up is essential to monitor the risk of relapse.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16221-e16221
Author(s):  
Oksana V. Katelnitskaya ◽  
Oleg I. Kit ◽  
Yuriy A. Gevorkyan ◽  
Aleksandr V. Snezhko ◽  
Oleg Yu. Kaymakchi ◽  
...  

e16221 Background: Restoration the hepatic arterial blood flow is required in traumatic or iatrogenic damage to the hepatic artery and its branches, as well as in the planned resection of the hepatic artery with subsequent reconstruction. Various ways have been proposed to solve this problem: ligation of the hepatic artery and its branches, which is associated with an extremely high mortality rate, reaching 70%, and the need for extensive liver resections; portal vein arteriolization; transposition of the splenic artery with its severe complications (heart attack, abscess) or hepatic artery replacement sometimes are not available and imply aggressive anticoagulant therapy, which is often challenging after extensive oncological interventions. Prosthetic vascular grafts are associated with a high risk of infection. We propose replacement of the common hepatic artery defect by transposition of the left gastric artery and end-to-end anastomosis between the proximal end of the left gastric artery and the distal end of the hepatic artery. Methods: The proposed method was applied in 7 cancer patients - 4 cases of iatrogenic damage to the common hepatic artery in lymph node dissection of the hepatoduodenal ligament and 3 resection of the common hepatic artery with tumor infiltration. The mean age of patients was 53 years. 2 patients had surgery for gastric cancer, 5 - pancreatic cancer. Results: The vascular reconstruction lasted for 17 minutes. No thrombotic complications of the reconstruction area or liver necrosis in the postoperative period were registered. The main advantages of this method were the absence of synthetic materials or deficit blood supply to neighboring organs, and no need for extensive mobilization of the great vessels in other areas (renal artery, abdominal aorta). Conclusions: The proposed method for reconstruction of the hepatic artery allows performing a simple and adequate restoration of the hepatic arterial blood flow, reduced time of the vascular stage of the surgery and reduced incidence of postoperative complications associated with the vascular stage - reduced time of liver ischemia and reduced risk of thrombosis in the reconstruction area.


Sign in / Sign up

Export Citation Format

Share Document