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  • Title: Direct intrahepatic portacaval shunt: an experimental study.
    Author: Luo JJ, Yan ZP, Zhou KR, Qian S.
    Journal: World J Gastroenterol; 2003 Feb; 9(2):324-8. PubMed ID: 12532459.
    Abstract:
    AIM: To determine the feasibility of creating direct intrahepatic portacaval shunt (DIPS) in swine with puncture under sonographic guidance. METHODS: DIPS was created in 10 domestic swine under sonographic guidance. Liver function, blood ammonia level and portosystemic gradient (PSG) were compared before and after the procedure. Patency of shunt was followed by portography every 7 days after DIPS. RESULTS: DIPS was successfully established in all 10 swine without any complications. One day after procedure the alanine aminotransferase (ALT), aspartate aminotransferase (AST), and blood ammonia level (BAL) of swine rose from 5.40+/-0.69, 16.00+/-0.79 and 35.66+/-4.10 to 34.20+/-3.46, 59.70+/-2.22 and 66.94+/-3.44 respectively. (P<0.05). The PSG decreased from 0.59+/-0.20 kPa to 0.24+/-0.11 kPa after DIPS (P<0.05). The shunt of 10 swine was kept patent from 7-28 days (median patency time was 14 days). CONCLUSION: This initial experience demonstrated that creating intrahepatic portacaval shunt from retrohepatic segment of IVC to portal vein with puncture under sonographic guidance in swine is safe and feasible. Further studies are necessary to perform DIPS in cirrhosis patients.
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