PREOPERATIVE EVALUATION IN ESTIMATED HEPATIC ARTERIAL BLOOD FLOW AFTER OCCLUSION OF CELIAC ARTERY IN CONSIDERATION OF APPLEBY'S OPERATION

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  • Appleby手術症例に対し術前肝血流量を予知した1例

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Abstract

It has been reported that Appleby's operation can be associated with fatal complications due to liver failure, though it is unusual. We evaluated preoperatively estimated hepatic arterial blood flow (EHAF) and liver functions before Appleby's operation for a pancreatic body carcinoma. At the conventional angiography, a celiac arterial balloon catheter and a hepatic venous cannule were inserted. After occlusion of the celiac artery, we calculated EHAF and evaluated the arterial ketone body-ratio (AKBR), EHAF decreased to 56% of the level before the procedure and AKBR to 0.51 after 20 minutes of the celiac occlusion. But these measurements recovered the original levels after 18 hours. In this study, we con-firmed the safety in the operation and performed distal pancreaticosplenectomy with celliac arterial resection. No liver dysfunction occurred in postoperative period except ischemic gastric ulcer.

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