Abstract
To evaluate the morphological effects of injected sclerosing agents into the liver. This study was performed on twenty dogs, distributed into five groups: Group 1 (n = 5) - control, Group 2 (n = 5) - injection of 50% glucose solution inside hepatic parenchyma and animals followed during seven days, Group 3 (n = 10) - injection of ethanol inside hepatic parenchyma and animals distribution into two subgroups Subgroup 3A (n = 5) - followed during 24 hours and subgroup 3B (n = 5) - followed during seven days (group 3B), Group 4 (n = 5) - ethanol injection inside left portal vein branch and followed during 24 hours. Livers were macroscopically evaluated, submitted to hepatic arteriography and portography, then histology. All animals in Group 4 died within 23 hours due to diffuse hepatic necrosis. The animals of groups 2 and 3 had a satisfactory evolution. Fibrosis formed in the segment reached by the sclerosant solution and interruption of the contrast flow injected into the portal system. Intrahepatic parenchymal ethanol injection is well tolerated and causes sclerosis restricted to a specific segment; however, intraportal ethanol injection causes massive hepatic necrosis and can lead to death.
Highlights
Liver surgery has been improved in the last decades, but the most critical aspect of this procedure is still the parenchymal resection due to the high blood loss[1,2,3]
This work was approved by the Committee of Ethics in Animal Experimentation (CETEA), Universidade Federal de Minas Gerais (UFMG), in accord with Brazilian law the Council for International Organization of Medical Sciences-CIOMS and under the protocol number 007/2008. 4
The livers preserved the lobular architecture, but microcystic dilations in the hepatic parenchyma were observed at histology
Summary
Liver surgery has been improved in the last decades, but the most critical aspect of this procedure is still the parenchymal resection due to the high blood loss[1,2,3]. Arterial embolization, blood interruption by tapes or clamps, as well as previous intraparenchymal small vessels ligation and greasing the hepatic parenchyma with several different substances are well accepted procedures[1,2,3,4,5,6,7]. Another possibility is the intravascular and intraparenchymal injection of sclerosing substances that seal the small vessels, controlling a diffuse hemorrhage[8,9,10,11].
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