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KMID : 0365719990150010141
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Journal of Pusan Surgical Society
1999 Volume.15 No. 1 p.141 ~ p.149
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Experimental Study on Optimal Duration of Intermittent Hepatic Vascular Clamping
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Sim Mun-Sup
Kim Hae-Young
Bae Young-Tae
Kim Dong-Heon
Moon Sang-Eun
Sol Mi-Young
Son Han-Chul
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Abstract
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>Background/Aims : During partial liver resection, intermittent hepatic pedicle clamping results in less hepatocyte damage than continous clamping. But, the optimal duration of ischemia and leperfusion during the intermittent hepatic vascular clamping is not determined. So, this study is aimed to determine the optimal duration of ischemia and reperfusion.
Methods : Using partial isehemia(70%) rat model, maximum limit of ischemic time and minimum limit of reperfusion 6me were evaluated. To assess the maximum limit of ischemic time, the rats were divided into three groups for 15, 20, 30 minutes of ischemia followed by 60 minutes reperfusion. To assess the minimum limit of reperfusion time, reperfusion following 15-minute ischemia was repeated 10 rimes in three groups for 5, 10, 15 minutes of reperfusion. In the ischemic experiments, hepatic blood flow and ATP levels were serially measured. In the reperfusion experiments, serum liver enzyme, 1 month survival rates, as well as, hepatic blood flow, ATP level were serially fieasured and then, 1 month survival rate was comoared between continuous ischemic group and n t 01 ermittent ischemic groups.
Results : (1) In the 15-minutes ischemic group, the hepatic blood flow and ATP levels were returned to preischemic value after 1 hour of reperfusion. But, in the 20 or 30 minutes ischemic groups, the hepatic blood flow and ATP levels were not returned to preischemic value. (2) In the 15-minutes reperfusion group, the survival rate and hepatic function,,; blood flow and ATP levels were better than 5 or 10 minutes reperfusion groups, such ashepatic
Conclusion :In 70% partial ischemic rat model, the maximum limit of ischemic time was 15 minutes. In case of intermittent ischemia and reperfusion, there was less liver damage. in 15,E minutes reperfusion group rather than 5 or 10 minutes reperfusion groups.
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KEYWORD
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Intermittent hepatic vascular clamping
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