Stomach Go Door The Venous Circulation Devascularization Hepatic Portal Hypertension Canine Gastric Mucosa Microvascular Ultrastructure

Objective To evaluate the influence of de-splanchnic circulation of stomach (DSCS) on ultramicrostructure of gastric mucosa and submucosal microcirculation in prehepatic portal hypertensive canine models.Methods We established prehepatic portal hypertensive canine models by half constriction and silk line chronic embolization of portal vein. The esophageal varices and collateral circulation were observed by venography after 4 weeks of modeling. The formed canine models were divided into pericardial devascularization (PCDV) group (PCDV) and DSCS group randomly.We measured the portal venous pressure (PVP) and esophageal variceal pressure (EVP) respectively by puncturing superior mesenteric vein and pericardial varices before surgery, immediately after surgery and 4 weeks after surgery. We also tested the liver function preoperatively and 4 weeks after surgery. The ultrastructure was observed by transmission electron microscopy 4 weeks postoperatively.Results 1. The PVP was decreased significantly from 23.64±0.40cmH2O to 20.62±0.97cmH2O after DSCS (P<0.01). The EVP was decreased significantly from 22.14±0.93cmH2O to 17.84±0.36cmH2O after DSCS (P<0.01).2. There was no obvious different changes in the liver function preoperatively and postoperatively (P>0.05).3. The gastric mucosal lesions in DSCS group were lighter than that in PCDV group 4 weeks after surgery. Ultrastructure showed that the microvillus of gastric epithelium cells were interrupted and fell off and that microvillus significantly reduced. Moreover, it was also shown that the basal lamina of submucosal veinule endothelial cells were uneven thick and discontinuous and that red blood cells could be obviously gathered in the endothelial cells interspace in pericardial devascularization group. There were less damages in the gastric musosa epithelia and submucosal venule endothelial cells in DSCS group.Conclusion DSCS can distinctly reduce the portal venous pressure and esophageal varicose vein pressure and improve the ultramicrostructure of gastric mucosa and submucosal microcirculation in canine models with prehepatic portal hypertension.