THE SAFETY OF TOTAL HEPATIC VASCULAR OCCLUSION IN RABBITS WITH ACUTE EXTRAHEPATIC CHOLESTASIS

The technique of normothermic total hepatic vascular occlusion (THVO) is achieved by concomitant clamping of the inferior vena cava above an d below the liver in addition to portal inflow occlusion. In this stud y we investigated the use of THVO for 45 min in a rabbit model with ac ute cholestasis of 10 days' duration, In rabbits with normal preoperat ive liver functions (control group), serum total bilirubin, glutamic-p yruvic transaminase (SGPT), glutamic-oxaloacetic transaminase (SGOT), alkaline phosphatase, and gamma-glutamyltranspeptidase levels returned to normal ranges within a week after THVO. In the group with persiste nt cholestasis THVO was performed 10 days after ligation of the extrah epatic bile duct, Total bilirubin and canalicular enzymes remained hig h while the SGOT and SGPT peaked and almost returned to the preoperati ve levels at 7 days following THVO in this group. A third group of ani mals also underwent THVO 10 days after ligation of their extrahepatic bile ducts with relief of the obstruction with a Teflon stent immediat ely after THVO. This group also showed the trend of normalization of l iver canalicular and parenchymal enzymes and bilirubin by the end of 7 days. This study demonstrated the feasibility of THVO in rabbits with acute extrahepatic cholestasis whether the extrahepatic biliary obstr uction persisted or not.