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    PIIS1365182X1600157X

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    60'041 Kanin Tianbud
    1) The study aimed to compare the effects of splenectomy and splenic artery ligation on splanchnic hemodynamics in swine. 2) Portal vein flow, hepatic artery flow, portal vein pressure, and hepatic venous pressure gradient were measured before and after simulated splenectomy or splenic artery ligation in pigs that underwent 70% or 90% hepatectomy. 3) The results showed that neither splenectomy nor splenic artery ligation had any impact on portal vein flow, hepatic artery flow, or hepatic venous pressure gradient regardless of the extent of hepatectomy.

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    PIIS1365182X1600157X

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    1) The study aimed to compare the effects of splenectomy and splenic artery ligation on splanchnic hemodynamics in swine. 2) Portal vein flow, hepatic artery flow, portal vein pressure, and hepatic venous pressure gradient were measured before and after simulated splenectomy or splenic artery ligation in pigs that underwent 70% or 90% hepatectomy. 3) The results showed that neither splenectomy nor splenic artery ligation had any impact on portal vein flow, hepatic artery flow, or hepatic venous pressure gradient regardless of the extent of hepatectomy.

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    1) The study aimed to compare the effects of splenectomy and splenic artery ligation on splanchnic hemodynamics in swine. 2) Portal vein flow, hepatic artery flow, portal vein pressure, and hepatic venous pressure gradient were measured before and after simulated splenectomy or splenic artery ligation in pigs that underwent 70% or 90% hepatectomy. 3) The results showed that neither splenectomy nor splenic artery ligation had any impact on portal vein flow, hepatic artery flow, or hepatic venous pressure gradient regardless of the extent of hepatectomy.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    17 views1 page

    PIIS1365182X1600157X

    Uploaded by

    60'041 Kanin Tianbud
    1) The study aimed to compare the effects of splenectomy and splenic artery ligation on splanchnic hemodynamics in swine. 2) Portal vein flow, hepatic artery flow, portal vein pressure, and hepatic venous pressure gradient were measured before and after simulated splenectomy or splenic artery ligation in pigs that underwent 70% or 90% hepatectomy. 3) The results showed that neither splenectomy nor splenic artery ligation had any impact on portal vein flow, hepatic artery flow, or hepatic venous pressure gradient regardless of the extent of hepatectomy.

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    of 1

    e694 E-AHPBA: Poster Abstracts

    insufficiency which resolved without intervention within Aims: Splenectomy and splenic artery ligation may
    30 postoperative days. Mean length of stay in hospital was prevent Small-For-Size Syndrome and post-hepatectomy
    5 days for the other four patients. liver failure after liver transplant or major hepatectomy.
    Conclusions: ALPPS has become an established approach The main goals of such procedures is to modulate
    to major liver resection and a feasible option for patients the liver inflow. However there is no consensus about
    previously deemed to have inoperable disease. Robotic their indication or the choice of the procedure. We
    ALPPS affords better access to and control of intrahepatic conducted an experimental study in swine to compare
    vasculature without the need to manipulate and mobilise the efficacy of these procedures on splanchnic
    the liver, and is, therefore, a safer approach for patients with hemodynamics.
    multiple comorbidities, metabolic syndrome and cirrhosis, Methods: 12 pigs were used for the study. We performed
    sensitive to haemodynamic changes during surgery. It also a simulation of splenectomy and a simulation of splenic
    affords faster postoperative recovery and return to normal artery ligation on each of them (fig 1). The procedures
    activities and is, therefore, preferable to open surgery. were performed either at the basal status (H0, n = 5), or
    after 70% hepatectomy (H70, n = 4), or after 90% hepa-
    tectomy (H90, n = 3). Portal vein flow (PVF) and hepatic
    LIVER 0271 artery flow (HAF) were recorded with a transit-flow
    recorder. Portal vein pressure and inverior vena cava
    HEPATIC RESECTION FOR BREAST
    pressure were recorded with intravascular Millar captors,
    CANCER LIVER METASTASES in order to calculate the Hepatic Venous pressure Gradient
    N. Bacalbasa1, S. Dima2, I. Balescu3, V. Brasoveanu2 and (HVPG).
    I. Popescu2 Results: PVF increased after H70 and H90, HVPG
    1
    Carol Davila University of Medicine and Pharmacy; increased after H90. There was no impact of both
    2
    Dan Setlacec Fundeni Clinical Institute Bucharest; simulation of splenectomy and splenic artery ligation on
    3
    Ponderas Hospital Bucharest, Romania HAF, PVF or HVPG, in any group. A comparison of the
    Aims: To demonstrate the benefit of liver resection for splenic vein flow-to-PVF in 8 pigs and 6 humans
    hepatic metastases from breast cancer and to identify the showed that it was inferior in swine (9% vs 31%,
    most important predictors of survival. p < 0,001).
    Methods: Forty-three patients with breast cancer liver Conclusions: Splenectomy and splenic artery ligation
    metastases were submitted to liver resection for breast don’t modulate the liver inflow in swine. We assume that
    cancer liver metastases in Fundeni Clinical Institute be- the large bowel length and the very small splenic volume in
    tween 2002e2014. swine explain why these procedures don’t modulate the
    Results: The mean age at the moment of liver resection was liver inflow in this animal.
    52 years (range 31e79 years); 81,4% of cases received
    preoperative chemotherapy or hormone-therapy before
    liver resection. Four patients were diagnosed with syn- LIVER 0276
    chronous liver metastases while in the other 39 cases LIVER INFLOW ADAPTATION AFTER
    metachronous lesions were found. Multiple liver lesions
    were found in 19 cases while in 10 cases the largest tumor
    MAJOR HEPATECTOMIES IS
    dimension surpassed 5 cm. Major hepatic resections EXPLAINED BY THE HEPATIC
    (involving more than 3 segments) were performed in 14 COMPLIANCE
    cases while in the other 29 cases minor hepatic resections B. Darnis, K. Mohkam, Z. Schmitt, S. Duperret, J. P. Vial,
    (of less than 3 segments) were needed. The overall C. Ducerf and J. Y. Mabrut
    morbidity rate was 16% while early postoperative mortality Croix-Rousse University Hospital, France
    rate was 0. In univariate analysis solitary versus multiple Aims: Small-for-size syndrome is one of the main limiting
    liver metastases and tumoral dimension < 5 cm were sig- factors for the regeneration of the remnant liver after
    nificant prognostic factors (33,2 months versus 25,3 extended hepatectomy. It is related to an imbalance be-
    months, p = 0,005 respectively 32,2 months versus 22,5 tween excessive portal venous inflow and insufficient liver
    months p = 0,006); major hepatectomies were not associ- volume. Increase in portal vein flow (PVF) or in hepatic
    ated with a poorer outcome when compared to minor re- veinous pressure gradient (HVPG) are predictors of SFSS
    sections (p = 0,086). although no correlation between these values has been
    Conclusions: Liver resection for breast cancer metastases established. We conducted an experimental study in swine
    is safe and can provide survival benefit especially in pa- to assess the adaptation of the liver inflow after major and
    tients with solitary, lesser than 5 cm lesions. subtotal hepatectomies.
    Methods: 14 pigs underwent systemic and splanchnic he-
    modynamics recording (PVF, HVPG , HAF : hepatic artery
    LIVER 0275 flow) before and after 70% hepatectomy (H70 : n = 7) or
    SPLENECTOMY AND SPLENIC ARTERY 90% hepatectomy (H90 : n = 7). To evaluate the liver
    LIGATION IN SWINE: NO IMPACT ON compliance, we used Ohm’s law formula : PVR = HVPG/
    PVF.
    PORTAL VEIN AND HEPATIC ARTERY
    Results: PVF increased after H70 (273 vs 123 ml/min/100g
    FLOW p = 0.016) and H90 (543 vs 124 ml/min/100g p = 0.031).
    B. Darnis, K. Mohkam, Z. Schmitt, S. Duperret, J. P. Vial, HVPG significantly increased only after H90 (10 vs
    C. Ducerf and J. Y. Mabrut 3,7mmHg p = 0.016). PVR was two times lower after H70
    Croix-Rousse University Hospital, France whereas it increased after H90. (fig1)

    HPB 2016, 18 (S2), e685ee738

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