PDF(Pubmed)
Abstract：
UNASSIGNED: Laparoscopic surgery is used for canine congenital extrahepatic portosystemic shunts (CEHPSS). However, outcomes of laparoscopic surgery involving simultaneous portal vein angiography and portal pressure measurement to attenuate or completely occlude the shunt vessel in canines remain unclear. This study aimed to evaluate outcomes and complications of laparoscopic portosystemic shunt occlusion (LAPSSO) for CEHPSS.
UNASSIGNED: Between June 2014 and March 2021, data on dogs undergoing cellophane banding (CB) and complete occlusion of laparoscopically treated congenital extrahepatic port shunts were collected from hospital records. Cases in which complete occlusion was laparoscopically performed, or a CB was used for gradual occlusion were included. A total of 36 dogs (14 males; median age 32.5 months [range, 5-99] with median body weight, 4.2 kg [range, 1.5-7.9]) that underwent LAPSSO for CEHPSS were included. All the dogs underwent computed tomographic angiography (CTA), and data on blood and radiological examinations were collected. Shunt vessel morphology was categorized using CTA findings. Portal pressure measurements and portal angiography were performed by accessing mesenteric and splenic veins in 30 and 6 cases, respectively.
UNASSIGNED: The most common shunt types were spleno-phrenic shunts 16/36 (44.4%), followed by spleno-azygos 9/36 (25.0%), spleno-caval 4/36 (11.1%), right gastric-caval 6/36 (16.6%), and right gastric-caval with caudal loop shunts 1/36 (2.7%). The median portal pressure after complete occlusion was 11.5 mmHg (range, 4-16); portal pressures in the two dogs undergoing CB attenuation were 22 and 24 mmHg. The median operating time in the dogs with right (n = 25) and left (n = 11) recumbent positioning was 55 min (range, 28-120) and 54 min (range, 28-88), respectively. One dog had pneumothorax due to injury to the diaphragm. Another dog developed postoperative hypernatremia and succumbed 5 h post-procedure. Nevertheless, no other dogs exhibited signs of portal hypertension within 72 h. Blood tests and abdominal ultrasounds performed 1-2 months postoperatively revealed no residual shunts.
UNASSIGNED: LAPSSO, coupled with portal pressure measurement and portal angiography, was shown as safe and effective approach that facilitated successful occlusion of CEHPSS. Further large-scale prospective studies and analyses of perioperative complications are needed.
UNASSIGNED: Between June 2014 and March 2021, data on dogs undergoing cellophane banding (CB) and complete occlusion of laparoscopically treated congenital extrahepatic port shunts were collected from hospital records. Cases in which complete occlusion was laparoscopically performed, or a CB was used for gradual occlusion were included. A total of 36 dogs (14 males; median age 32.5 months [range, 5-99] with median body weight, 4.2 kg [range, 1.5-7.9]) that underwent LAPSSO for CEHPSS were included. All the dogs underwent computed tomographic angiography (CTA), and data on blood and radiological examinations were collected. Shunt vessel morphology was categorized using CTA findings. Portal pressure measurements and portal angiography were performed by accessing mesenteric and splenic veins in 30 and 6 cases, respectively.
UNASSIGNED: The most common shunt types were spleno-phrenic shunts 16/36 (44.4%), followed by spleno-azygos 9/36 (25.0%), spleno-caval 4/36 (11.1%), right gastric-caval 6/36 (16.6%), and right gastric-caval with caudal loop shunts 1/36 (2.7%). The median portal pressure after complete occlusion was 11.5 mmHg (range, 4-16); portal pressures in the two dogs undergoing CB attenuation were 22 and 24 mmHg. The median operating time in the dogs with right (n = 25) and left (n = 11) recumbent positioning was 55 min (range, 28-120) and 54 min (range, 28-88), respectively. One dog had pneumothorax due to injury to the diaphragm. Another dog developed postoperative hypernatremia and succumbed 5 h post-procedure. Nevertheless, no other dogs exhibited signs of portal hypertension within 72 h. Blood tests and abdominal ultrasounds performed 1-2 months postoperatively revealed no residual shunts.
UNASSIGNED: LAPSSO, coupled with portal pressure measurement and portal angiography, was shown as safe and effective approach that facilitated successful occlusion of CEHPSS. Further large-scale prospective studies and analyses of perioperative complications are needed.
摘要：
■腹腔镜手术用于犬先天性肝外门体分流术（CEHPSS）。然而,同时进行门静脉血管造影和门静脉压力测量以减弱或完全闭塞犬分流血管的腹腔镜手术的结果尚不清楚。本研究旨在评估腹腔镜门体分流术（LAPSSO）对CEHPSS的疗效和并发症。
■在2014年6月至2021年3月之间，从医院记录中收集了接受玻璃纸绑扎（CB）和腹腔镜治疗的先天性肝外分流口完全闭塞的狗的数据。腹腔镜完全闭塞的病例，或用于逐渐闭塞的CB被包括在内。共有36只狗（14只雄性；中位年龄32.5个月[范围，5-99]中等体重，4.2kg[范围,1.5-7.9]）包括接受LAPSSO治疗CEHPSS的患者。所有的狗都接受了CT血管造影(CTA),收集血液和放射学检查的数据。使用CTA发现对分流血管形态进行分类。30例和6例通过进入肠系膜和脾静脉进行门静脉压力测量和门静脉造影，分别。
■最常见的分流类型是脾-膈分流16/36（44.4%），其次是脾奇9/36(25.0%)，脾腔4/36(11.1%),右胃腔6/36（16.6%），右侧胃腔静脉有尾环分流1/36(2.7%)。完全闭塞后的中位门静脉压为11.5mmHg（范围，4-16）；两只进行CB衰减的狗的门静脉压为22和24mmHg。右卧位（n=25）和左卧位（n=11）的狗的中位手术时间为55分钟（范围，28-120)和54分钟(范围，28-88),分别。一只狗由于隔膜受伤而发生气胸。另一只狗出现术后高钠血症，并在术后5小时死亡。然而，没有其他狗在72小时内表现出门脉高压的迹象。术后1-2个月进行的血液检查和腹部超声检查显示没有残留的分流。
■LAPSSO，结合门静脉压力测量和门静脉血管造影，被证明是促进CEHPSS成功闭塞的安全有效方法。需要对围手术期并发症进行进一步的大规模前瞻性研究和分析。
■在2014年6月至2021年3月之间，从医院记录中收集了接受玻璃纸绑扎（CB）和腹腔镜治疗的先天性肝外分流口完全闭塞的狗的数据。腹腔镜完全闭塞的病例，或用于逐渐闭塞的CB被包括在内。共有36只狗（14只雄性；中位年龄32.5个月[范围，5-99]中等体重，4.2kg[范围,1.5-7.9]）包括接受LAPSSO治疗CEHPSS的患者。所有的狗都接受了CT血管造影(CTA),收集血液和放射学检查的数据。使用CTA发现对分流血管形态进行分类。30例和6例通过进入肠系膜和脾静脉进行门静脉压力测量和门静脉造影，分别。
■最常见的分流类型是脾-膈分流16/36（44.4%），其次是脾奇9/36(25.0%)，脾腔4/36(11.1%),右胃腔6/36（16.6%），右侧胃腔静脉有尾环分流1/36(2.7%)。完全闭塞后的中位门静脉压为11.5mmHg（范围，4-16）；两只进行CB衰减的狗的门静脉压为22和24mmHg。右卧位（n=25）和左卧位（n=11）的狗的中位手术时间为55分钟（范围，28-120)和54分钟(范围，28-88),分别。一只狗由于隔膜受伤而发生气胸。另一只狗出现术后高钠血症，并在术后5小时死亡。然而，没有其他狗在72小时内表现出门脉高压的迹象。术后1-2个月进行的血液检查和腹部超声检查显示没有残留的分流。
■LAPSSO，结合门静脉压力测量和门静脉血管造影，被证明是促进CEHPSS成功闭塞的安全有效方法。需要对围手术期并发症进行进一步的大规模前瞻性研究和分析。
