MORPHOMETRIC ANALYSIS REMODELING VESSELS HEMOMICROCIRCULATORY BED OF JEJUNUM AT RESECTIONS OF LIVER

  • M.S. Hnatjuk I.Ya.Horbachevsky Ternopil State Medical University, Department of Operative Surgery and Topographic Anatomy, Ternopil, Ukraine
  • L.V. Tatarchuk I.Ya.Horbachevsky Ternopil State Medical University, Department of Operative Surgery and Topographic Anatomy, Ternopil, Ukraine
Keywords: jejunum, remodeling, hemomicrocirculatory bad, resection of liver

Abstract

Liver resection is widely used in modern surgical departments. Removal of large volumes of the liver leads to postresection portal hypertension, which is complicated by bleeding from varicose veins of the esophagus, stomach, rectum, ascites, splenomegaly with secondary hypersplenism, parenchymal jaundice and portosystemic encephalopathy. The widespread prevalence of this pathology, high mortality from its complications indicates that it is an important medical and social problem. The aim of the study is quantitative morphological study of the features of remodeling the vessels of the hemomicrocirculatory bad of the jejunum at resection of different volumes of the liver. The studies were conducted on 45 sexually mature male rats, which were divided into 3 groups. The first group consisted of 15 intact virtually animals, 2-15 rats after resection of the left lateral part – 31.5% of the parenchyma of the liver, 3-15 animals after resection of the right and left lateral parts of the liver (58.1%). Euthanasia of experimental animals was carried out by bloodletting in conditions of thiopental anesthesia 1 month after the beginning of the experiment. The hemomicrocirculatory bad of the jejunum was studied by injection of its vessels into the carcass-gelatinous mixture, which was injected through the abdominal aorta. From the jejunum, lightened and histologic preparates were prepared and morphometrically studied the vessels of the microhemocirculatory bed. Quantitative indicators were processed statistically, the difference between the comparative values was determined by the Student's criterion. It was established that the severity of structural transformation of the vessels of the microhemocirculatory bad of the jejunum depends on the volume of the removed parenchyma of the liver. The analysis of the obtained results revealed that one month after resection of 31.5% of liver parenchyma, the morphometric parameters of the vessels of the haemomicrocirculatory bad of the jejunum were insignificantly altered. It was determined that resection of 58.1% of liver parenchyma caused postresection portal hypertension and marked remodeling of blood vessels of the hemomicrocirculatory bad of the jejunum, which was characterized by narrowing of arterioles by 23.4%, precapillary arterioles by 22.8%, hemocapillaries by 22.9%%, decrease in the density of microvessels – by 22.4%, the expansion of the capillary venules – by 35.5% and venules – by 28.7%, venous plethora, hypoxia, dystrophy, necrobiosis of cells and tissues, infiltrative processes and sclerosis. Resection of 58.1% of liver parenchyma leads to postresection portal hypertension, pronounced narrowing of lumen of the vessels of the adnexa and exchange units hemomicrocirculatory bed, expansion of the postcapillary venules and venules, venous plethora, hypoxia, dystrophy and necrobiosis of cells and tissues, infiltrative and sclerotic processes in wall of the jejunum.

Downloads

Download data is not yet available.

References

[1] Avtandilov, G. G. (2002). Basic of Quantitative Pathological Anatomy. Moscow: Medicine. ISBN: 978-5-225-04151-9
[2] Hnatiuk, M. S., Tatarchuk, L. V., & Yasinovskyy, O. B. (2016). Morphometric evaluation of the features of remodeling of duodenal structures during resection of different volumes of the liver. Scientific Journal of Uzhhorod University. Series “Medicine”, 1(49), 3-5.
[3] Kotenko, O. H., Popov, A. O., & Grynenko, A. V. (2017). Resection portal vein in treatment perychylar cholangiokarcinomy. Ukr. J. Surgery, 4(35), 10–17.
[4] Lapach, S. N., Gubenko, A. V., & Babich P. N. (2001). Statistical methods in medicobiological investigation Excell. Kiev: Morion. ISBN: 966-7632-33-4
[5] Reznikov, O. G. (2003). General ethical principles of experiments on animal. Endokrinology, 8(1), 142–145.
[6] Sarkisov, D. S. (1987). Structural basis adaptation and compensation damage function. Moscow: Medicine. ISBN (В пер.) (В пер.): 2 р.
[7] Shulgai, A. H., Tatarchuk, L. V., & Hnatiuk, M. S. (2017). Remodeling peculiarities of ileum hemomicrocirculatory bed vessels at resection of different liver size. Scientific Journal of investigation, 4, 145–149.
[8] Sorochinnikov, A. G., & Dorosievich, A. Ye. (2007). Histologikal and microskopic equipments. Moscow: Mediсine.
[9] Fiodorov, V. D., Vishnievskiy, V. A., & Nazarienko, N. A. (2007). The main complication of extensive liver resection and ways to prevent them. Bulletin of Siberian Medicine, 4, 16–24.
[10] Vishnievskiy, V. A., Yefanov, M. G., & Kazakov, I. V. (2012). Segmentar resection, long-term results in malignant liver tumors. Ukr. J. Surgery, 1(16), 5-15.
[11] Adam, R. (2003). Chemotherapy and surgery: new perspectives on treatment of unresectable liver metastasis. Ann. Oncol., 14(2), 13–16.
[12] Are, C., Gonen, M., & Zazzali, K. (2007). The impact of margins on outcome after hepatic resection for colorectal metastasis. Ann. Surg., 246(2), 295–390. DOI: 10.1097/SLA.0b013e31811ea962
[13] de Franchis, R., & Baveno, V. F. (2010). Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J. Hepаtol., 53(4), 762–768. doi: 10.1016/j.jhep.2010.06.004.
[14] Lai, H. E. I., & Lai, E. C. (2007). Hepatic rezection for colorectal liver metastases. Singapor Med. J., 48(7), 635–639.
[15] Nakajima, K., Takanashi, S., & Saito, N. (2013). Efficacy of the predicted operation time strategy for syndronous colorectal liver metastasis feasibility study for staged resection in patients in long predicted operation time. Gastrointest. Surg., 17(4), 688–695.
[16] Nanashima, A., Sumida, Y., & Abo, T. (2008). A modified grading system for post-hepatectomy metastasis liver cancer originating form colorectal carcinoma. J. Surg. Oncol., 98(5), 363–370.
[17] Neuman, U. P., Sechofer, D., & Neuhaus, D. (2010). The surgical treatment of hepatic metastasis in colorectal carcinoma. Dtsch. Arztebl. Int., 107(19), 335–342. doi: 10.3238/arztebl.2010.0335
[18] Ogata, Y., Nishi, M., & Nakayama, H. (2003). Role of bile in intestinal barrier function and its inhibitory effect on bacterial translocation in obstructive jaundice in rats. J. Surg. Res., 115(1), 18–23.
[19] Paravecino, M., Chun, I. S., Madoff, D. C., Zorzi, D., Kishi, Y., Kaseb, A. O. ... Vauthey, J. N. (2009). Major hepatic resection for hepatocellular carcinoma with or without portal vein embolization: Perioperutive outcome and survival. Surgery, 145(4), 399–405. doi: 10.1016/j.surg.2008.10.009.
[20] Reddy, S. S., & Civan, J. M. (2016). From Child-Pugh to Model for End-Stage Liver Discase: Deciding Who Needs a Liver Transplant. Med. Clin. Noth. Am., 100(3), 449֪–464.
[21] Rialon, K. L., Murillo, R., Fevurly, R. O., Kulungowski, A. M., Zurakowski, D., Liang, M. … Fishman, S. J. (2015). Impact of screening for hepatic hemangioma in patients with multiple cutaneous infantile hemangiomas. Pediatr. Dermatol., 32(6), 162–167. doi: 10.1111/pde.12656.
[22] Sass, D. A., & Chopra, K. B. (2009). Portal hypertension and variceal hemorrhage. Med. Clin. North Am., 93(4), 837–853. doi: 10.1016/j.mcna.2009.03.008.
[23] Salloum, C., & Castaing, D. (2008). Surgical margin status in hepatectomy for liver tumor. Bull. Cancer., 95(12), 1183–1191. DOI: 10.1684/bdc.2008.0758
[24] Sanyal, A. J., Bosch, J., Blei, A., & Arroyo, V. (2008). Portal hypertension and its complications. Gastroenterology, 134(6), 1715–1728. doi: 10.1053/j.gastro.2008.03.007.
[25] Sawada, K., Ohtake, T., & Veno, N. (2011). Multiple portal hypertensive polyps of the jejunum accompanied by anemia of the unknown origin. Gastrointest., Endosc., 73, 179–182.
[26] Taguchi, T., Iwanaka, T., & Okamatsu, T. (2016). Operative General Surgery in Neonates and Children. Springer Japan., 42, 398–399.
[27] Tsirline, V. B., Lau, K. N., Swan, R. Z., Montero, P. N., Sindram, D., Martinie, J.B., & Iannitti, D. A. (2013). Evaluation of an innovative. Cordes ultrasonic Dissector. Surg. Innov., 20(5), 524–529. doi: 10.1177/1553350612471206.
Published
2018-03-29
How to Cite
Hnatjuk, M., & Tatarchuk, L. (2018). MORPHOMETRIC ANALYSIS REMODELING VESSELS HEMOMICROCIRCULATORY BED OF JEJUNUM AT RESECTIONS OF LIVER. Reports of Morphology, 24(1), 16-20. https://doi.org/10.31393/morphology-journal-2018-24(1)-03