USE OF INTRAOPERATIVE MESENTERIC PORTOVENOGRAPHY IN CONGENITAL PORTOSYSTEMIC SHUNT SURGERY
Article first published online: 19 MAY 2005
Veterinary Radiology & Ultrasound
Volume 44, Issue 5, pages 514–521, September 2003
How to Cite
White, R. N., Macdonald, N. J. and Burton, C. A. (2003), USE OF INTRAOPERATIVE MESENTERIC PORTOVENOGRAPHY IN CONGENITAL PORTOSYSTEMIC SHUNT SURGERY. Veterinary Radiology & Ultrasound, 44: 514–521. doi: 10.1111/j.1740-8261.2003.tb00499.x
- Issue published online: 19 MAY 2005
- Article first published online: 19 MAY 2005
- Received September 10, 2002; accepted for publication January 27, 2003.
- dynamic intraoperative mesenteric portovenography;
- visual analogue scale;
- pre- and postligation portovenograms;
- portal atresia/hypoplasia
A retrospective study of the use of intraoperative mesenteric portovenography (IOMP) in the surgical management of congenital portosystemic shunts in 100 dogs and cats was performed. Each portovenogram was scored using a subjective visual analogue scale (VAS) and was assessed for the presence of portal atresia or hypoplasia. VAS scores and portal hypoplasia assessments were obtained for portovenogram images obtained for each animal both before shunt manipulation (preligation) and following the temporary, complete ligation of the vessel (postligation). In each patient, surgical records were reviewed to ascertain the degree of shunt attenuation that was achieved at surgery. Hepatic portal vasculature was significantly different on postligation compared with preligation IOMP. Sixty-two percent of animals had apparent portal hypoplasia or atresia on their preligation IOMP. The majority of these (81%) had an improvement in portal vasculature on postligation IOMP. It was concluded that both preligation and postligation IOMP provided valuable information regarding the morphology of congenital portosystemic shunts. An accurate assessment of an animal's portal vasculature could only be made following the interpretation of a postligation portovenogram, and these findings significantly influenced the surgical management of the patient. Although individuals with high postligation VAS scores were more likely to achieve full shunt attenuation at surgery, there was no quantifiable relationship between IOMP findings and the degree of shunt attenuation achieved.