Direct intrahepatic portacaval shunt: an experimental study

Area of Science:

• Interventional Radiology
• Hepatobiliary Surgery
• Animal Models

Background:

• Portal hypertension is a serious complication of liver disease.
• Direct intrahepatic portacaval shunt (DIPS) offers a potential treatment option.
• Sonographic guidance may improve the safety and efficacy of DIPS creation.

Purpose of the Study:

• To assess the feasibility and safety of creating DIPS in swine using sonographic guidance.
• To evaluate the impact of DIPS on liver function, ammonia levels, and portosystemic gradient.
• To determine the patency of the created DIPS.

Main Methods:

• Direct intrahepatic portacaval shunt (DIPS) was created in 10 domestic swine under sonographic guidance.
• Liver function tests, blood ammonia levels, and portosystemic gradient (PSG) were measured before and after the procedure.
• Shunt patency was monitored using portography every 7 days.

Main Results:

• DIPS was successfully created in all 10 swine without complications.
• Post-procedure, significant increases in ALT, AST, and blood ammonia levels were observed (P<0.05).
• The portosystemic gradient significantly decreased post-DIPS (P<0.05), and shunt patency was maintained for a median of 14 days.

Conclusions:

• Sonographically guided DIPS creation in swine is a safe and feasible procedure.
• The study demonstrates successful shunt creation and reduction in portosystemic gradient.
• Further research is warranted to evaluate DIPS in human patients with cirrhosis.