Effectiveness of Peripheral Hepatogastrostomy Versus Hepatojejunostomy in the Treatment of Obstructive Cholestasis: Results of an Experimental Model

Dahlke, Marc H.; Aselmann, H.; Ceylan, Dilek; Bellin, Tobias; Flemming, Peer; Meier, P. N.; Oldhafer, Karl J.; Klempnauer, J.; Piso, P.

doi:10.1007/s00595-003-2702-4

Cited by 1 publication

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“…Before the experiments, pigs remained fasting for 12 h with free access to water. In order to prevent gastric and duodenal ulceration, pantoprazol (80 mg) was daily administered from the day of admission of animals in ZPF [20]. …”

Section: Methodsmentioning

confidence: 99%

Evaluation of an ADVanced Organ Support (ADVOS) system in a two-hit porcine model of liver failure plus endotoxemia

Al-Chalabi

Matevossian

Thaden

et al. 2017

ICMx

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BackgroundNovel extracorporeal procedures are constantly being developed and evaluated for use in patients with sepsis. Preclinical evaluation of such procedures usually requires testing in large animal models. In the present work, the safety and efficacy of a recently developed ADVanced Organ Support (ADVOS) system in a newly developed large animal two-hit model of liver failure combined with endotoxemia were tested.MethodsAfter establishing the model in more than 50 animals, a randomized study was performed. An inflammatory cholestatic liver injury was initially provoked in pigs. Three days after surgery, endotoxin was gradually administered during 7½ h. Animals were randomized to receive standard medical treatment either with (ADVOS group, n = 5) or without ADVOS (control group, n = 5). The ADVOS treatment was started 2½ h after endotoxemia and continued for 7 h. Survival, cardiovascular, respiratory, renal, liver, coagulation, and cerebral parameters were analyzed.ResultsThree days after surgery, cholestatic injury resulted in hyperbilirubinemia [5.0 mg/dl (IQR 4.3–5.9 mg/dl)], hyperammonemia [292 μg/dl (IQR 291–296 μg/dl)], leukocytosis [20.2 103/μl (IQR 17.7–21.8 103/μl)], and hyperfibrinogenemia [713 mg/dl (IQR 654–803 mg/dl)]. After endotoxemia, the ADVOS procedure stabilized cardiovascular, respiratory, and renal parameters and eliminated surrogate markers as bilirubin [2.3 (IQR 2.3–3.0) vs. 5.5 (IQR 4.6–5.6) mg/dl, p = 0.001] and creatinine [1.4 (IQR 1.1–1.7) vs. 2.3 (IQR 2.1–3.1) mg/dl, p = 0.01]. Mortality: All animals in the ADVOS group survived, while all animals in the control group expired during the 10-h observation period (p = 0.002). No adverse events related to the procedure were observed.ConclusionsThe ADVOS procedure showed a promising safety and efficacy profile and improved survival in a sepsis-like animal model with dysfunction of multiple organs. An amelioration of major organ functions (heart and lung) combined with removal of markers for kidney and liver function was observed.Electronic supplementary materialThe online version of this article (doi:10.1186/s40635-017-0144-3) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Evaluation of an ADVanced Organ Support (ADVOS) system in a two-hit porcine model of liver failure plus endotoxemia

Al-Chalabi

Matevossian

Thaden

et al. 2017

ICMx

View full text Add to dashboard Cite

show abstract

Effectiveness of Peripheral Hepatogastrostomy Versus Hepatojejunostomy in the Treatment of Obstructive Cholestasis: Results of an Experimental Model

Abstract: A hepatogastrostomy represents an alternative treatment option for surgical bile drainage with a similar effectiveness to that of a hepatojejunostomy. To prevent postoperative gastrointestinal bleeding, proton pump inhibitors should be used.

Cited by 1 publication

References 12 publications

Evaluation of an ADVanced Organ Support (ADVOS) system in a two-hit porcine model of liver failure plus endotoxemia

Evaluation of an ADVanced Organ Support (ADVOS) system in a two-hit porcine model of liver failure plus endotoxemia

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