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  • Title: [Problems of hepatoportal encephalopathy after portacaval anastomosis in the rat (author's transl)].
    Author: Rasenack U, Grün M, Liehr H, Heine WD.
    Journal: Z Gastroenterol; 1980 Sep; 18(9):483-93. PubMed ID: 7456566.
    Abstract:
    Necrosis and injury of ganglia cells as well as alterations of the glia represent the morphological changes in portal-systemic encephalopathy. This is a frequent complication of a spontaneous or surgical porta-caval collateral circulation. Such changes can also be observed when porta-caval end-to-side anastomosis (PCA) was constructed in otherwise healthy rats. Increased incorporation rates of 3H-thymidine into the glia were indication for enhanced proliferating activity. Efforts done to maintain the pancreatic venous blood flow to the liver beside PCA resulted in significant diminuation of brain pathology and function. The latter measured by EEG. This happened although the grade of hyperammonemia was virtually identical in both settings. The interpretation is offered that access of the liver to hepatotrophic substances (i. e. insulin) from the pancreas prevents portal-systemic encephalopathy in PCA which is in agreement with data of the literature. The observation implies that in clinical action exclusively those surgical techniques should be used by which the venous blood supply from the pancreas to the liver is maintained.
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