Abstract
Objective - To evaluate the use of a portocaval venograft and ameroid constrictor in the surgical management of intrahepatic portosystemic shunts (PSS). Study Design - Prospective, clinical study. Animal Population - Ten client-owned dogs with intrahepatic PSS. Methods - Portal pressure was measured after temporary suture occlusion of the intrahepatic PSS. In dogs with an increase in portal pressure greater than 8 mm Hg, a single extrahepatic portocaval shunt was created using a jugular vein. An ameroid ring was placed around the venograft and the intrahepatic PSS was attenuated. Transcolonic pertechnetate scintigraphy was performed before surgery, 5 days after surgery, and 8 to 10 weeks after surgery. Dogs with continued portosystemic shunting were evaluated further by laparotomy or portography. Clinical outcome and complications were recorded. Results - Mean (± SD) portal pressure increased from 6 ± 3 to 19 ± 6 mm Hg with PSS occlusion; in all 10 dogs, the increase in portal pressure was greater than 8 mm Hg. There were no intraoperative complications, and, after creation of the portocaval shunt, the intrahepatic PSS could be completely ligated in 8 of 10 dogs. The final portal pressure was 9 ± 4 mm Hg. Postoperative complications included coagulopathy and death (1 dog), ascites (3 dogs), and incisional discharge (3 dogs). Five of 8 dogs had continued portosystemic shunting at 8 to 10 weeks after surgery. Multiple extrahepatic PSS were demonstrated in 4 of these dogs. Clinical outcome was excellent in all 9 surviving dogs. Conclusions and Clinical Significance - The surgical technique resulted in a high incidence of multiple extrahepatic PSS. Short-term clinical results were promising, but long-term outcome must be evaluated further.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 161-169 |
| Number of pages | 9 |
| Journal | Veterinary Surgery |
| Volume | 30 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 2001 |
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Evaluation of a portocaval venograft and ameroid ring for the occlusion of intrahepatic portocaval shunts in dogs. / Kyles, Andrew E.; Gregory, Clare R.; Jackson, Joshua; Ilkiw, Jan; Pascoe, Peter J; Adin, Christopher; Samii, Valerie F.; Herrgesell, Eric.
In: Veterinary Surgery, Vol. 30, No. 2, 03.2001, p. 161-169.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evaluation of a portocaval venograft and ameroid ring for the occlusion of intrahepatic portocaval shunts in dogs
AU - Kyles, Andrew E.
AU - Gregory, Clare R.
AU - Jackson, Joshua
AU - Ilkiw, Jan
AU - Pascoe, Peter J
AU - Adin, Christopher
AU - Samii, Valerie F.
AU - Herrgesell, Eric
PY - 2001/3
Y1 - 2001/3
N2 - Objective - To evaluate the use of a portocaval venograft and ameroid constrictor in the surgical management of intrahepatic portosystemic shunts (PSS). Study Design - Prospective, clinical study. Animal Population - Ten client-owned dogs with intrahepatic PSS. Methods - Portal pressure was measured after temporary suture occlusion of the intrahepatic PSS. In dogs with an increase in portal pressure greater than 8 mm Hg, a single extrahepatic portocaval shunt was created using a jugular vein. An ameroid ring was placed around the venograft and the intrahepatic PSS was attenuated. Transcolonic pertechnetate scintigraphy was performed before surgery, 5 days after surgery, and 8 to 10 weeks after surgery. Dogs with continued portosystemic shunting were evaluated further by laparotomy or portography. Clinical outcome and complications were recorded. Results - Mean (± SD) portal pressure increased from 6 ± 3 to 19 ± 6 mm Hg with PSS occlusion; in all 10 dogs, the increase in portal pressure was greater than 8 mm Hg. There were no intraoperative complications, and, after creation of the portocaval shunt, the intrahepatic PSS could be completely ligated in 8 of 10 dogs. The final portal pressure was 9 ± 4 mm Hg. Postoperative complications included coagulopathy and death (1 dog), ascites (3 dogs), and incisional discharge (3 dogs). Five of 8 dogs had continued portosystemic shunting at 8 to 10 weeks after surgery. Multiple extrahepatic PSS were demonstrated in 4 of these dogs. Clinical outcome was excellent in all 9 surviving dogs. Conclusions and Clinical Significance - The surgical technique resulted in a high incidence of multiple extrahepatic PSS. Short-term clinical results were promising, but long-term outcome must be evaluated further.
AB - Objective - To evaluate the use of a portocaval venograft and ameroid constrictor in the surgical management of intrahepatic portosystemic shunts (PSS). Study Design - Prospective, clinical study. Animal Population - Ten client-owned dogs with intrahepatic PSS. Methods - Portal pressure was measured after temporary suture occlusion of the intrahepatic PSS. In dogs with an increase in portal pressure greater than 8 mm Hg, a single extrahepatic portocaval shunt was created using a jugular vein. An ameroid ring was placed around the venograft and the intrahepatic PSS was attenuated. Transcolonic pertechnetate scintigraphy was performed before surgery, 5 days after surgery, and 8 to 10 weeks after surgery. Dogs with continued portosystemic shunting were evaluated further by laparotomy or portography. Clinical outcome and complications were recorded. Results - Mean (± SD) portal pressure increased from 6 ± 3 to 19 ± 6 mm Hg with PSS occlusion; in all 10 dogs, the increase in portal pressure was greater than 8 mm Hg. There were no intraoperative complications, and, after creation of the portocaval shunt, the intrahepatic PSS could be completely ligated in 8 of 10 dogs. The final portal pressure was 9 ± 4 mm Hg. Postoperative complications included coagulopathy and death (1 dog), ascites (3 dogs), and incisional discharge (3 dogs). Five of 8 dogs had continued portosystemic shunting at 8 to 10 weeks after surgery. Multiple extrahepatic PSS were demonstrated in 4 of these dogs. Clinical outcome was excellent in all 9 surviving dogs. Conclusions and Clinical Significance - The surgical technique resulted in a high incidence of multiple extrahepatic PSS. Short-term clinical results were promising, but long-term outcome must be evaluated further.
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U2 - 10.1053/jvet.2001.20333
DO - 10.1053/jvet.2001.20333
M3 - Article
VL - 30
SP - 161
EP - 169
JO - Veterinary Surgery
JF - Veterinary Surgery
SN - 0161-3499
IS - 2
ER -