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The shunt is completed by placing a special mesh tube known as a stent or endograft to maintain the tract between the higher-pressure portal vein and the lower-pressure hepatic vein. After the procedure, fluoroscopic images are made to show placement. Pressure in the portal vein and inferior vena cava are often measured. [citation needed]
In addition to the laparotomy to access the retrohepatic space, a thoracotomy is necessary to find the atrium so that the stent—usually a 36 French chest tube—can be inserted. The stent is secured with tourniquets. Problems during surgery involve uncontrollable bleeding and technical problems in placing the shunt in a timely fashion.
Liver regeneration is the process by which the liver is able to replace damaged or lost liver tissue. The liver is the only visceral organ with the capacity to regenerate. [ 1 ] [ 2 ] The liver can regenerate after partial hepatectomy or injury due to hepatotoxic agents such as certain medications, toxins, or chemicals. [ 3 ]
The Pringle manoeuvre is used during liver surgery and in some cases of severe liver trauma to minimize blood loss. [1] For short durations of use, it is very effective at reducing intraoperative blood loss. [2] The Pringle manoeuvre is applied during closure of a vena cava injury when an atriocaval shunt is placed. [citation needed]
Perihepatic packing is a surgical procedure used in connection with trauma surgery to the liver. In this procedure the liver is packed to stop non arterial bleeding, most often caused by liver injury. [1] During this surgery laparotomy pads are placed around the bleeding liver. [2]
Procedures frequently used to treat vascular damage from atherosclerosis and related narrowing and re-narrowing (restenosis) of blood vessels include vascular surgery, cardiac surgery, and angioplasty. [1] When a stent is used and restenosis occurs, this is called in-stent restenosis or ISR. [2]
Liver transplantation is a potential treatment for acute or chronic conditions which cause irreversible and severe ("end-stage") liver dysfunction. [4] Since the procedure carries relatively high risks, is resource-intensive, and requires major life modifications after surgery, it is reserved for dire circumstances. [citation needed]
The several types of hepatic artery treatments are based on the observation that tumor cells get nearly all their nutrients from the hepatic artery, while the normal cells of the liver get about 70-80 percent of their nutrients and 50% their oxygen supply from the portal vein, and thus can survive with the hepatic artery effectively blocked. [2]