Experimental study of protective of in-situ hypothermic liver perfusion on the ischemic liver with biliary obstruction in pigs

为减少全肝血流阻断及再灌注后的损伤，本研究采用猪门静脉及肝动脉原位冷灌注，用于肝癌、胆管细胞癌合并肝硬化及梗阻性黄疸的肝脏手术.原位低温灌注可使肝血管阻断（HVE）时及术后肝组织TAN水平高于热缺血组。原位低温灌注可预防肝脏缺血损伤.梗阻性黄疸时V-V转流和肝脏冷灌注的有效性研究梗阻性黄疸猪热缺血可引起更明显的肝细胞损伤，原位低温肝脏灌注不仅对正常肝脏而且对梗阻性黄疸时肝脏缺血时和缺血后的损伤均有保护作用.延长V-V转流和肝脏冷灌注的可行性研究原位低温灌注技术可减轻缺血再灌注损伤，尤其对UW液缺血180分钟的肝损伤有保护作用. PGI_2类似物（OP_（2507））对肝脏缺血再灌注损伤的保护作用研究PGI_2类似物具有细胞保护作用，能维持肝脏高能量代谢，对抗缺血再灌注损伤。PGI_2类似物在体肝脏冷灌注可预防肝脏长期缺血所致的损伤。

To minimize the damage during total hepatic vascular exclusion and after reperfusion, in-situ cold perfusion via portal vein and hepatic artery was carried out in pig for clinical application to liver surgery of hepatocellular carcinoma and cholangiocellular carcinoma with liver cirhosis and obstructive jaundice.1. Study of the usefulness of V-V bypass and cold perfusion of the liverIn-situ hypothermic perfusion could maintain hepatic TAN level higher than that of warm ischemia group during and sfter HVE (hepatic vascular exclusion). In-situ hypothermic perfusion could prevent the damage caused by liver ischemia.2. Study of the usefulness of V-V bypass and cold perfusion of the liver with obstructive jaundiceMore remarkable liver cell injury was induced by warm ischemia in pig with obstructive jaundice, and in-situ hypothermic perfusion of the liver could prevent the damages during and after liver ischemia not only in normal liver but also in the liver with obstructive jaundice.3. Study for the possibility of prologation of V-V bypass and cold perfusoin of the liverThe in-situ hypothermic perfusion technique is useful for reducing ischemia-reperfusion injury, and especially could protect the liver injury from 180 minutes ischemia of the liver with UW solution.4. Study for the protective effect of PGI2 analogue (OP2507) on liver ischemic injuryPGI2 analogue has a cytoprotective effect and maintains high energy metabolism of the liver against ischemic reperfusion injury. Administration of PGI2 analogue with in-situ liver cold perfusion could prevent the damage caused by prolonged liver ischemia.