Short-term effect of portal vein arterialization on hepatic protein synthesis and endotoxaemia after extended hepatectomy in dogs.

To assess the effect of partial portal arterialization on the remaining liver after usually lethal extended hepatectomy, 30 mongrel dogs underwent 84% partial hepatectomy and were divided into three groups as follows: group 1, 84% partial hepatectomy (72 = 10); group 2, 84% partial hepatectomy and splenectomy (n = 10); group 3, 84% partial hepatectomy and splenectomy and splenic artery-vein (A-V) shunt (it = 10). Another five dogs were pre-operatively killed normal controls. Portal vein flow (PVF) decreased to about 60% in groups 1 and 2, but PVF in group 3 was maintained at the preoperative level. Oxygen saturation of portal vein blood increased markedly, to between 83% (group 1) and 88% (group 3). Portal vein pressure (PVP) increased in groups 1 and 2 by 1.6 to 1.7 times the preoperative value, but no significant difference in PVP, serum aspartate aminotransferase (AST) and arterial ketone body ratio was found between the three groups. Plasma endotoxin levels after 84% partial hepatectomy were significantly lower in group 3 than in groups 1 and 2. Both of hepatocellular and secretory protein synthesis were enhanced in group 3 compared with the other two groups. These results suggest that partial portal arterialization using a splenic A-V shunt might bring about a beneficial effect on remaining liver function after extended hepatectomy.