Effects of splenohepatopexy and omentopexy in experimentally induced infrahepatic portal hypertension in rats.

The purpose of this study was to determine whether splenohepatopexy (SHP) or omental transposition (OP) could reverse the portal hypertension (PH) induced by portal vein ligation (PVL). Fifty-eight Wistar rats divided into four groups: in group A (22 rats) PH was produced by calibrated PVL. In group B (8 rats), SHP was performed. Group C animals (13 rats) underwent SHP and PVL. In group D (15 rats) both PVL and OP were done. In all of the rats, the portal pressures (PP) were measured before and after the production of PVL. For SHP, small areas on the spleen and liver capsula were stripped off, and these two areas were placed together. In group D, an omentum patch was tied on the prepared liver surface. Twelve weeks after surgery, the PP were measured again and portal angiography was done. The liver, omentum and spleen were histopathologically examined. In all of the groups, the PP after PVL were significantly higher than before PVL. Twelve weeks after surgery, the PP of SHP and OP groups were significantly lower than those with PVL alone. Angiographic study showed many collaterals between transposed tissue and liver. Histopathologically, the collaterals of animals with SHP or OP were found to be well developed to allow sufficient flow for PP reduction. Both SHP and OP may reverse the increased PP in PVL model of PH. In the future; these methods may be alternative techniques for PP reduction in human beings as well.