Journal of Liver: Disease & TransplantationISSN: 2325-9612

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Research Article, J Liver Dis Transplant Vol: 3 Issue: 1

Early Changes in Smallfor- Flow Syndrome: An Experimental Model

Asencio JM1*, Steiner MA1, G Sabrido JL1, López Baena JA1, Ferreiroa JP1, Morales A1, Lozano P1, Peligros I2, Laso J3, Herrero M3, Lisbona C3, Pérez-Peña JM3 and Olmedilla L3
1Department of General Surgery, Gregorio Marañon University General Hospital, Madrid, Spain
2Department of Histopathology, Gregorio Marañon University General Hospital, Madrid, Spain
3Department of Anesthesiology, Gregorio Marañon University General Hospital, Madrid, Spain
Corresponding author : Dr. José Manuel Asencio Pascual
Department of General Surgery, Liver Transplant Unit, Gregorio Marañon University General Hospital, c/ O’Donnell, 6, 28009, Madrid, Spain
Tel: +34 626 948 426
E-mail: [email protected]
Received: May 16, 2013 Accepted: January 14, 2014 Published: January 18, 2014
Citation: Asencio JM, Steiner MA, G Sabrido JL, López Baena JA, Ferreiroa JP, et al. (2013) Early Changes in Small-for-Flow Syndrome: An Experimental Model. J Liver: Dis Transplant 3:1. doi:10.4172/2325-9612.1000115

Abstract

Early Changes in Smallfor- Flow Syndrome: An Experimental Model

The aim of the present study is to present an experimental model of the early changes in hemodynamic and histological values after hyperextended hepatectomy. Intraoperative findings are important, because early control of damage could prevent the development of small-for-flow syndrome. Sequential liver segmentectomy was performed under general anesthesia in 11 minipigs until 80% of the parenchyma was resected. After each resection, histological samples of remnant parenchyma were taken and values recorded for portal flow, portal pressure, arterial hepatic flow, suprahepatic vein pressure, arterial pressure, and cardiac frequency. This hyperextended hepatectomy model reproduces the changes observed in small-for-flow syndrome. The hemodynamic and histological changes observed are immediate; therefore, they should be prevented during surgery by modulating pressure and portal flow. Intraoperative measurement of pressure and portal flow should be part of the therapeutic and diagnostic algorithms of patients who undergo major hepatic resection.

Keywords: Small for size syndrome; Portal flow; Portal pressure; Hepatectomy; small-for-flow syndrome

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