Splenic Artery Ligation and Portocaval Shunt in Small-for-size Syndrome

NCT05459883 | Completed

• 1 other identifier: 418/18-04-2022
• Study Type: observational
• Target: 13
• Locations: 1 country
• Sites: 1

Brief Summary

Our study aimed at assessing the changes of portal vein pressure, portal vein flow and hepatic arterial flow (HAF) in liver remnants ≤ 30% of the standard liver volume by reducing portal vein overflow via ligation of the splenic artery.

Conditions

Small-For-Size Liver Syndrome; Ligation; Liver Regeneration; Splenic Artery; Portal Vein; Ischemia; Reperfusion Injury; Hepatectomy

Keywords

small-for-size liver syndrome; ligation; splenic artery; hepatectomy; liver regeneration

Outcome Measures

Primary Outcomes (3)

• portal vein pressure

  change of portal vein pressure from before liver resection to after reperfusion of the liver remnant

  through the operation, an average period of two hours

• portal vein flow

  change of portal vein flow from before liver resection to after reperfusion of the liver remnant

  through the operation, an average period of two hours

• hepatic artery flow

  change of hepatic artery flow from before liver resection to after reperfusion of the liver remnant

  through the operation, an average period of two hours

Interventions

splenic artery ligation PROCEDURE

We identified portal hyperperfusion as a cause of potential small-for-size liver remnant dysfunction and we applied splenic artery ligation as a technically simple procedure to manage the situation

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

retrospective analysis of an internal hepatectomy database

You may qualify if:

• Adult patients
• American Society of Anesthesiologists (ASA) distribution I to III
• Patients scheduled for major liver resection (≥4 segments)

You may not qualify if:

• patients with extrahepatic disease
• patients with metastatic liver tumors

Sponsors & Collaborators

• Aretaieion University Hospital: lead

Study Sites (1)

Aretaieion University Hospital

Athens, Attica, 11528, Greece

Location

Related Publications (5)

• Theodoraki K, Arkadopoulos N, Nastos C, Vassiliou I, Karmaniolou I, Smyrniotis V. Small liver remnants are more vulnerable to ischemia/reperfusion injury after extended hepatectomies: a case-control study. World J Surg. 2012 Dec;36(12):2895-900. doi: 10.1007/s00268-012-1779-6.

  PMID: 22956015 BACKGROUND

• Garcia-Valdecasas JC, Fuster J, Charco R, Bombuy E, Fondevila C, Ferrer J, Ayuso C, Taura P. Changes in portal vein flow after adult living-donor liver transplantation: does it influence postoperative liver function? Liver Transpl. 2003 Jun;9(6):564-9. doi: 10.1053/jlts.2003.50069.

  PMID: 12783396 BACKGROUND

• Kinaci E, Kayaalp C. Portosystemic Shunts for "Too Small-for-Size Syndrome" After Liver Transplantation: A Systematic Review. World J Surg. 2016 Aug;40(8):1932-40. doi: 10.1007/s00268-016-3518-x.

  PMID: 27160453 BACKGROUND

• Lo CM, Liu CL, Fan ST. Portal hyperperfusion injury as the cause of primary nonfunction in a small-for-size liver graft-successful treatment with splenic artery ligation. Liver Transpl. 2003 Jun;9(6):626-8. doi: 10.1053/jlts.2003.50081.

  PMID: 12783407 BACKGROUND

• Umeda Y, Yagi T, Sadamori H, Matsukawa H, Matsuda H, Shinoura S, Mizuno K, Yoshida R, Iwamoto T, Satoh D, Tanaka N. Effects of prophylactic splenic artery modulation on portal overperfusion and liver regeneration in small-for-size graft. Transplantation. 2008 Sep 15;86(5):673-80. doi: 10.1097/TP.0b013e318181e02d.

  PMID: 18791439 BACKGROUND

MeSH Terms

Conditions

Ischemia; Reperfusion Injury

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Vascular Diseases; Cardiovascular Diseases; Postoperative Complications

Study Officials

• Kassiani Theodoraki

  Aretaieion University Hospital, Athens, Greece

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Anesthesiology

Study Record Dates

• First Submitted: July 10, 2022
• First Posted: July 15, 2022
• Study Start: January 1, 2017
• Primary Completion: December 31, 2021
• Study Completion: December 31, 2021
• Last Updated: July 15, 2022

Record last verified: 2022-07

Data Sharing

• IPD Sharing: Will not share

Locations

GR (1)