The Impact of Cross-Clamping of The Portal Triad on The Morphology of The Small Intestine

Abstract

At present, clamping of the portal triad is a widespread surgical procedure in hospitals. Such an operation can prevent pathological changes in the organs. However, the optimal time for clamping remains unclear. To determine the starting time of irreversible morphological changes in the small intestine due to the clamping of the portal triad. The study was carried out on rats (n=94). Animals were randomly subdivided into 4 groups based on the duration of clamping of the portal triad (PT): I control group (CG; without clamping the PT; n=10); II intervention group (6-IG; clamping PT for 6 min; n=28); III intervention group (12-IG; clamping time of the PT for 12 min; n=28); IV intervention group (24-IG; clamping time of the PT for 24 min; n=28). In groups 6- IG, 12-IG, 24-IG, after clamping the portal triad, animals were withdrawn from the experiment after 3 hours, 6 hours, 12 hours, 1 day, 3 days and 7 days. Morphological changes in the small intestine were assessed by measuring the diameter of the lumen of micro-vessels. In addition, the mortality in the groups was analysed as well. In the CG group, the diameter of the arterioles of the small intestine was 34±4 μm, the diameters of pre-capillaries were 15±2μm, the capillaries were 5.4±1 μm, the post-capillaries were 18±2 μm, and the diameter of the lumen of the venues was 40±3 μm. In the 6-IG group (on the 3rd day), the structure of the small intestine showed the recovery signs. By the 7th day, the indicators returned to their original values. In the 12-IG group, the parameters of the small intestine were restored on the seventh day that corresponds to the usual course of the disease. However, in the 24-IG group, changes in these organs persisted until the end of the study. No deaths were reported in the CG and 6-IG animal groups. Mortality among rats of the 12-IG group was 14.3%, while in the 24-IG group with PT clamping for 24 minutes it was 42.8%, respectively. The morphological changes in the microvasculature of the small intestine after 6-minute PT clamping showed a tendency to recover (back to the control parameters). Nevertheless, after 24 minutes of clamping, the changes in the intestinal tissue were irreversible.