Evaluation of a portocaval venograft and ameroid ring for the occlusion of intrahepatic portocaval shunts in dogs

Andrew E. Kyles, Clare R. Gregory, Joshua Jackson, Jan Ilkiw, Peter J Pascoe, Christopher Adin, Valerie F. Samii, Eric Herrgesell

Research output: Contribution to journalArticle

38 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)161-169
Number of pages9
JournalVeterinary Surgery
Volume30
Issue number2
DOIs
StatePublished - Mar 2001

Fingerprint

Surgical Portasystemic Shunt
Dogs
Portal Pressure
dogs
surgery
ameroid
Portography
Sodium Pertechnetate Tc 99m
scintigraphy
postoperative complications
laparotomy
Jugular Veins
ascites
Intraoperative Complications
jugular vein
sutures
Ambulatory Surgical Procedures
Ascites
Radionuclide Imaging
Laparotomy

ASJC Scopus subject areas

  • veterinary(all)

Cite this

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 journalArticle

Kyles, Andrew E. ; Gregory, Clare R. ; Jackson, Joshua ; Ilkiw, Jan ; Pascoe, Peter J ; Adin, Christopher ; Samii, Valerie F. ; Herrgesell, Eric. / Evaluation of a portocaval venograft and ameroid ring for the occlusion of intrahepatic portocaval shunts in dogs. In: Veterinary Surgery. 2001 ; Vol. 30, No. 2. pp. 161-169.
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