ABSTRACT
The two most promising surgical animal models of fulminant hepatic failure (FHF) for investigation of the safety and efficacy of new treatment modalities were analyzed in a porcine study. Animals underwent total hepatectomy or devascularization of hepatic artery and portal vein followed by portocaval (PC) shunting. Survival time, technical feasibility, safety, and reproducibility of the models were investigated. Devascularization seems to be most useful for studying the development and treatment of FHF caused by ischemia and its side effects. Total hepatectomy is superior for investigation of the anhepatic status and treatment of FHF by bioartifical liver support systems.
Subject(s)
Hepatectomy , Liver Failure, Acute/physiopathology , Vascular Surgical Procedures/methods , Animals , Disease Models, Animal , Feasibility Studies , Female , Hepatic Artery/surgery , Ligation , Liver/blood supply , Liver/physiopathology , Models, Animal , Portal Vein/surgery , Swine , Treatment OutcomeABSTRACT
PURPOSE: To assess, in a pig model, the value of dual-modality positron emission tomography (PET)/computed tomography (CT) for monitoring radiation therapy. MATERIALS AND METHODS: Central bile duct resection followed by creation of a biliodigestive anastomosis was performed in nine pigs. Six of these pigs were also treated with intraoperative radiation therapy (IORT) (20 Gy) in the area of the anastomosis. Two, 4, and 8 weeks postoperatively, contrast material-enhanced fluorine 18 fluorodeoxyglucose (FDG) PET/CT of the liver was performed in all of the animals. The radioactive tracer concentration in the region of the anastomosis was quantified, and the values were compared intraindividually with the values at the liver periphery. Histologic evaluation of the liver was performed 8 weeks postoperatively. The PET/CT images were assessed for changes in liver volume and bile duct diameter over time. RESULTS: In all nine pigs, the region of the anastomosis could be clearly defined on the fused PET/CT images. PET/CT revealed a decreased concentration of FDG in the irradiated field 2 and 4 weeks after IORT. At 8 weeks, however, the distribution of the tracer in the irradiated pigs did not differ from that in the nonirradiated pigs. Homogeneous tracer uptake in all liver regions was observed in the nonirradiated animals. The CT images showed an increase in liver volume in all pigs and bile duct dilatation that increased over time in the irradiated pigs. CONCLUSION: The morphologic and functional changes due to IORT in liver tissue can be accurately monitored with dual-modality PET/CT. By enabling the integration of functional and morphologic data, PET/CT may have an important role in monitoring radiation treatment.
Subject(s)
Anastomosis, Roux-en-Y , Bile Ducts, Extrahepatic/radiation effects , Bile Ducts, Extrahepatic/surgery , Brachytherapy , Hepatic Artery/radiation effects , Hepatic Duct, Common/radiation effects , Image Interpretation, Computer-Assisted , Jejunum/radiation effects , Jejunum/surgery , Liver/radiation effects , Portal Vein/radiation effects , Radiation Injuries, Experimental/diagnosis , Tomography, Emission-Computed , Tomography, X-Ray Computed , Animals , Brachytherapy/instrumentation , Combined Modality Therapy , Dilatation, Pathologic/pathology , Energy Metabolism/radiation effects , Female , Fluorodeoxyglucose F18 , Hepatic Artery/pathology , Hepatic Duct, Common/pathology , Liver/pathology , Liver Regeneration/radiation effects , Necrosis , Particle Accelerators , Portal Vein/pathology , Radiation Injuries, Experimental/pathology , Sensitivity and Specificity , SwineABSTRACT
There is a need for prolonged anesthesia procedures in experimental surgery. Animals in this study received fentanyl, Midazolam, and Propofol administered by continuous intravenous infusion for anesthesia along with controlled ventilation. Time of anesthesia was 413 +/- 95 min. Animals could be extubated 20 +/- 12 min after operation. Animals recovered completely from anesthesia by day 1 after surgery with almost normal physical activity. This study clearly shows that intravenous infusion anesthesia is safe and easy to handle in prolonged anesthesia for experimental surgery in swine. This anesthetic protocol can also be used for intraoperative transportation.
