[Collateral circulation after the division of the common hepatic artery--experimental study in dogs]

The influence of division of the common hepatic artery (CHA) was studied using dogs, by measuring the blood flow of the proper hepatic artery (PHA) by an electromagnetic flowmeter, and tissue blood flow of the liver and the gallbladder by the H2 gas clearance method. The results expressed as relative values (value before the division of CHA = 1.0) were as follows. 1) PHA blood flow decreased to 0.40 +/- 0.18 (n = 14) after the division of CHA. 2) After the division of CHA, tissue blood flow of the liver decreased to 0.61 +/- 0.16 (n = 27), and tissue blood flow of the gallbladder, to 0.51 +/- 0.16 (n = 40). After additional occlusion of the gastroduodenal artery, these values were 0.51 +/- 0.16 and 0.23 +/- 0.13, respectively. 3) On the seventh day after CHA division, tissue blood flow of the gallbladder recovered to 0.84 +/- 0.50. 4) Necrosis of the gallbladder, which was mostly partial was found in 20% of the experimental dogs at autopsy. These results showed that there is effective arterial collateral circulation after division of the CHA, which makes Appleby's operation practicable. However, considering the degree of ischemia observed in the gallbladder, preservation of collaterals during Appleby's operation will be essential for the prevention of necrosis of the gallbladder.