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Results for “VEINS, PORTAL SYSTEM”

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At least 73 records · Page 4Linked to original sources
PubMed2003

Resection of hepatocellular carcinoma in a patient with congenital anomaly of the portal system.

Hepatic resection in a patient with an anomalous portal vein system is presented. A 53-year-old man was referred to our hospital for hepatic resection. Preoperative computed tomography (CT) and angiography demonstrated that the umbilical portion of the portal vein gave off major branches to the right anterior segment, and the hepatic tumor was located on the dorsal side of one of the right anterior portal branches near the umbilical portion. Partial hepatic resection was performed using the indocyanine green staining technique under operative echo guidance. Limited hepatic resection was indicated due to the patient's poor hepatic reserve function. His postoperative course was uneventful. This case emphasizes the importance of delineating the hepatic vascular anatomy before and during operation, especially in the case of an anomalous portal vein system.

Carcinoma, Hepatocellular↗
PubMed1994

Treatment of portal vein thrombosis by thrombectomy and regional thrombolysis.

BACKGROUND: Portal vein thrombosis is a rare disorder. The prognosis of both the acute and the chronic forms is determined by the resulting acute or chronic portal hypertension. The therapeutic approach of choice is controversial. METHODS: A case of etiologically unclear thrombosis of the portal vein system in a young man is reported, which was treated successfully by means of portal vein thrombectomy combined with intraoperative and postoperative thrombolysis with recombinant tissue plasminogen activator (rTPA). RESULTS: Initial thrombectomy established sufficient venous return. However, rethrombosis of the portal vein occurred 2 days later. In a second operation rethrombectomy was followed by intraoperative regional application of rTPA, which was continued after operation during a period of 48 hours through a catheter inserted in a mesenteric vein. Patency of the portal system was confirmed 1 week after the procedure. The 1-year follow-up reconfirmed this result (through indirect portography and Doppler sonography). The patient received the anticoagulant phenprocoumon. CONCLUSIONS: The combination of surgical thrombectomy and regional thrombolysis with rTPA could offer a feasible therapeutic option for selected patients with acute prehepatic portal vein thrombosis.

Acute Disease↗
PubMedDate not supplied

[Experimental grounds of a new concept of Opisthorchis felineus infection formation in a definitive host].

In the course of experiments in was found out that golden hamsters having the bilious duct operationally blocked display receptivity to the infection with the non-excysted Opisthorchis felineus metacercariae passed to the stomach. Excysted metacercariae injected to the system of the portal vein settle down in the bilious pathways of the liver and develop there up to the adult stage. In vitro, the metacercariae survive in the blood serum of the intact golden hamsters during one day. Based on the experiments, it is hypothesized that the early stage of O. felineus infection in the bilious duct of definitive hosts is performed by means of hematogenic migration of metacercariae through the portal veins system from the mucous layer of the alimentary tract of the host.

Animals↗
PubMed2001

Selective radioprotection of hepatocytes by systemic and portal vein infusions of amifostine in a rat liver tumor model.

PURPOSE: The tolerance of the liver to radiation is too low to permit an effective dose to be delivered to patients who have diffuse intrahepatic cancer. In this study we evaluated whether systemic or portal venous administration of the aminothiol compound, amifostine, could protect the normal liver from the effects of ionizing radiation without compromising tumor cell kill in a rat liver tumor model. METHODS AND MATERIALS: Rats implanted with liver tumors were infused with 200 mg/kg amifostine over 15 min via the femoral or portal vein. The livers were irradiated with a single 6-Gy fraction 15-20 min after the termination of amifostine infusion. Protection of the liver was assessed by an in vitro hepatocyte micronucleus assay and tumor protection by an in vivo-in vitro clonogenic survival assay. Tissue levels of the active metabolite, free WR-1065, were determined in the tumor and in the normal liver using a specific HPLC assay with electrochemical detection. RESULTS: After a 6-Gy fraction, the frequency of hepatocyte micronuclei after administration of saline, systemic amifostine, and portal venous amifostine was 18.7+/-1%, 6.8+/-1%, and 9.9+/-2%, respectively, corresponding to a radiation equivalent effect of 6 Gy +/- 0.5, 1.8 Gy +/- 0.3, and 2.5 Gy +/- 1.3, respectively. Both amifostine conditions showed considerably less radiation effect than saline-treated controls (p < 0.01); the two amifostine conditions did not differ (p = 0.3). The surviving fraction of tumor cells was not affected by amifostine treatment and was 0.03+/-0.02 and 0.05+/-0.03 for systemic and portal venous delivery and 0.06+/-0.02 for control animals (ANOVA analysis showed no significant difference of the means p = 0.34). Portal venous delivery produced significantly less WR-1065 in the tumor compared to systemic administration (54 microM +/- 36 vs. 343 microM +/- 88, respectively, p = 0.03). CONCLUSIONS: Both systemic and portal venous administration of amifostine effectively protect hepatocytes from ionizing radiation without compromising tumor cell kill in a clinically relevant animal model. These findings suggest that amifostine may be a selective normal tissue radioprotectant in liver cancer and that regional/portal infusions may be preferable to systemic dosing.

Amifostine↗
PubMed1996

Systemic and portal vein delivery of human kallikrein gene reduces blood pressure in hypertensive rats.

There is an inverse correlation between systemic blood pressure and urinary kallikrein levels in humans and hypertensive animal models, suggesting that the tissue kallikrein-kinin system plays an important role in blood pressure regulation. In this study, we explored the potential of human kallikrein gene delivery on blood pressure reduction in spontaneously hypertensive rats (SHR). The human tissue kallikrein gene or cDNA was placed under the control of following promoters: the metallothionein gene metal response-element (MRE-pHK), albumin gene (ALB-pHK), Rous sarcoma virus 3' long terminal repeat (LTR) (RSV-cHK), and cytomegalovirus (CMV-cHK). A single injection of these kallikrein DNAs results in a significant reduction of blood pressure in SHR, which lasts for 5-6 weeks. Systemic delivery of CMV-cHK, RSV-cHK, and MRE-pHK has a greater effect on blood pressure reduction than ALB-pHK, whereas intraportal vein gene delivery of ALB-pHK is more effective than the other kallikrein DNA constructs. The degree of blood pressure reduction depends on the amount of administered DNA and the age of the animals. Reduction of blood pressure was observed in adult, but not young, SHR. The expression of human tissue kallikrein in rats was identified by an ELISA that is specific for human tissue kallikrein. No antibodies to either human tissue kallikrein or its DNA were detected in rat sera after somatic gene delivery. These results show that somatic gene delivery of human tissue kallikrein causes a lowering effect of systolic blood pressure in genetically hypertensive rats and provide valuable information for kallikrein gene therapy in the treatment of hypertension.

Animals↗
PubMed2003

Simultaneous aberrant left and right gastric veins draining directly into the liver.

Aberrant gastric veins draining directly into the liver are rare variations of the portal vein system. We report on an autopsy in which both right and left gastric veins drained directly into the liver without joining the portal vein. Although the left gastric artery adopted a standard disposition, the left gastric vein was indeed found to ascend from the lesser curvature through the upper part of the lesser omentum. After receiving branches from the gastroesophageal junction, it directly entered the left part of the porta hepatis. The right gastric vein ascended from the lesser gastric curvature along and in front of the right aspect of the common bile duct without ending in the portal vein. It crossed in front of the common hepatic duct and directly entered the porta hepatis. Careful dissection within the liver parenchyma showed that both gastric veins ended in the intra-hepatic part of the left branch of the portal vein. Although aberrant gastric veins are known variations of the portal vein system, the conjunction of both right and left gastric vein has never been reported. It highlights the possibility that the venous drainage of the gastric lesser curvature may be totally independent of the main portal vein.

Autopsy↗
PubMed1996

Peripancreatic veins on thin-section (3 mm) helical CT.

OBJECTIVE: The purpose of this study was to evaluate thin-section helical CT for the frequency of visualization of the peripancreatic veins, the venous anatomy at the head of the pancreas, and variations of the venous anatomy. SUBJECTS AND METHODS: We performed 30-sec helical CT of the pancreas with one breath-hold and a 3-mm scanning collimation in 50 patients. The scan was started 60 sec after injection of an i.v. contrast medium at the rate of 2 ml/sec (total amount of contrast medium, 100 ml). The axial scan data were reviewed for the following information: the frequency of CT visualization of the peripancreatic veins (anterior superior pancreaticoduodenal vein, first jejunal vein, gastrocolic trunk, inferior mesenteric vein, left gastric vein, middle colic vein, posterior superior pancreaticoduodenal vein, right colic vein, and right gastroepipolic vein) and the anatomic relationship between the large portal venous system (portal vein, superior mesenteric vein, and splenic vein) and its tributaries. RESULTS: The frequency of visualization on CT of each vessel was gastrocolic trunk, 100%; right gastroepiploic vein, 100%; first jejunal vein, 96%; inferior mesenteric vein, 88%; left gastric vein, 80%; posterior superior pancreaticoduodenal vein, 72%; middle colic vein, 72%; right colic vein, 64%; and anterior superior pancreaticoduodenal vein, 50%. The anatomic relationship between the large portal venous system and its tributaries was as follows: The left gastric vein drained into the splenic vein-portal vein confluence (46%), into the splenic vein (32%), and into the portal vein (22%); the inferior mesenteric vein drained into the splenic vein (46%), the splenic vein-superior mesenteric vein confluence (25%), and the superior mesenteric vein (29%). The posterior superior pancreaticoduodenal vein drained into the portal vein above the splenic vein-portal vein confluence (mean distance, 0.3 cm). The middle colic vein, gastrocolic trunk, and first jejunal vein drained into the superior mesenteric vein below the splenic vein-portal vein confluence (mean distances of 2.4 cm, 3.0 cm, and 3.7 cm, respectively). CONCLUSION: Thin-section helical CT scans provide good visualization of the peripancreatic veins.

Abdomen↗
PubMedDate not supplied

Duplex-Doppler ultrasonography in the evaluation of cirrhotic patients with portal hypertension and in the analysis of their response to drugs.

Sixteen patients (15 males, aged 48-70) affected by liver cirrhosis and oesophageal varices were subjected to duplex-Doppler ultrasonographic study (DDUS). Four patients (three with a portal thrombosis and one with a hepatofugal portal flow) were excluded from the subsequent pharmacological test. The twelve remaining patients took part in a double blind cross-over study that evaluated the variations of heart rate (HR), mean systemic arterial pressure (SAP), portal vein diameter (PVD), maximal and mean portal flow velocity (PFV) after the administration of either 40 mg of propranolol or placebo per os, on two consecutive days. Propranolol caused no significant variation in mean SAP and in PVD, whereas it reduced the HR from 67.7 +/- 8.0 to 58.4 +/- 7.0 beats/min (mean +/- s.d.; P less than 0.001); the maxPFV dropped from 18.2 +/- 5.4 to 14.0 +/- 3.7 cm/s (P less than 0.001) and the meanPFV dropped from 15.3 +/- 4.1 to 13.2 +/- 3.1 cm/s (P less than 0.005). No significant variation was observed with placebo. After propranolol administration eight patients exhibited a significant maxPFV decrease, whereas the other four patients exhibited only a drop in HR, suggesting either drug inefficacy, inappropriate dosage or inadequate duration of treatment. DDUS is the only non-invasive method for the examination of the portal vein system.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗