Hemodynamic and biochemical changes during total hepatic vascular exclusion in dogs.

Twelve healthy Beagles were divided into 3 groups of 4 dogs each. To compare 2 methods of total hepatic vascular exclusion (THVE), we investigated the hemodynamic changes during THVE and assessed the influences on hepatic, renal and pancreatic biochemistry and the complications after THVE. In Group A, the thoracic aorta, hepatic pedicle and prehepatic and posthepatic caudal vena cava were occluded for 20 min, while in Group B, the celiac and cranial mesenteric arteries, hepatic pedicle and prehepatic and posthepatic caudal vena cava were occluded for 20 min. In Group C, a sham operation was performed. The arterial, venous and portal venous pressures and serum biochemistry parameters were measured before and during THVE and for 30 min after reperfusion. The carotid arterial pressure did not change in Group A during THVE, but decreased in Group B. The femoral and portal venous pressures in Group B increased significantly during THVE compared with those in Group C. With the exception of alanine aminotransferase, the serum biochemical profiles remained unchanged after the operation. For 7 days after the operation, no complications were observed in any of the dogs. In conclusion, occlusion of thoracic aorta, hepatic pedicle and prehepatic and posthepatic caudal vena cava is a feasible and safe method of hepatic vascular occlusion. This technique appears to be effective for canine hepatic surgery, such as removal of a large right-divisional hepatic tumor and attenuation of intrahepatic portosystemic shunt.