DIFFERENT DURATIONS OF PORTAL VEIN LIGATION IN RATS

Ertan Bülbüloğlu; Mustafa Şahin; Bülent Kantarçeken; Harun Çıralık; Ali Çetinkaya; Fatma İnanç; Fikret Ezberci

DIFFERENT DURATIONS OF PORTAL VEIN LIGATION IN RATS

Yıl 2005, Cilt: 2 Sayı: 2, 47 - 55, 01.06.2005

Ertan Bülbüloğlu Mustafa Şahin Bülent Kantarçeken Harun Çıralık Ali Çetinkaya Fatma İnanç Fikret Ezberci

Öz

Aim: Atrophy/Hypertrophy complex constitution (AHC) by portal vein ligation (PVL) before major hepatectomies (Hx) has got beneficial effects on the functional capacity of the remnant liver tissue by increasing its volume. We aimed to evaluate whether longer duration of PVL has any additive benefit on regenaration speed, weight, biochemical, histological examination and mortality, before major hepatectomies in rats. Methods: One-hundred and twenty Wistar Albino rats were divided into four groups (PVL, PVL+Hx, Hx, Sham+Hx). Group I ( PVL ), Group II ( PVL + Hx ); 70% Hx and relaparotomy after 21 days from PVL, Group III ( Hx ); 70% Hx, Group IV ( Sham + Hx); 70% Hx after 21 days from Sham ligation. Hepatic tissue regeneration speed, weight, liver function tests and histological examination were evaluated on postoperatively 3rd , 7th , 14th and 21st days. Also, mortality rate was evaluated. Results: The regeneration speed increased in all groups except PVL+Hx. The weight of all rats decreased on postoperative 3rd day, however, then reached nearly preoperative values on 7th day and the higher values were seen on 28th day in all groups. Serum alkaline phosphatase levels increased in all groups postoperatively and decreased to normal values on postoperative 7th day. Mitosis has been seen until 3rd day in Hx, and Sham+Hx, until 14th day in PVL, and not in PVL+Hx. 1, 6, and 7 rats were lost in PVL+Hx, Hx, and Sham+Hx groups respectively in first three days. Mortality rates were significantly lower than Hx and Sham+Hx groups in PVL and PVL+Hx groups Conclusion: In this study the lesser liver tissue had to be resected in rats constituted AHC with long term PVL, so we had more remnant liver tissue to be able to have enough function. The lengthening of the duration of PVL will be better for decreasing morbidity and mortality of major hepatectomies in benign liver pathologies. Key words: Portal vein ligation, Atrophy, Hypertrophy, Hepatectomy, Liver, Rat.

Anahtar Kelimeler

Kaynakça

1. Farges O. Belghiti J. Kianmanesh R, Regimbeau JM, Santoro R, Vilgrain V. Portal vein embolization before right hepatectomy. Ann Surg 2003;237:208-17
2. Broering CD, Hillert C, Krupski G, Fisher L, Mueller L, Achilles EG. Portal vein embolization vs. portal vein ligation for ýnduction of hypertrophy of the future liver remmant. J Gastrointest Surg 2002;6: 905-13
3. Madoff CD, Hicks EM, Vauthey JN, Charnsangavej C, Morello FA. Transhepatic portal vein embolization: anatomy, indications, and technical considerations. Radiographics 2002;22: 1063-76
4. Tanaka H, Kinoshita H, Hirohashi K, Kubo S, Lee KC. Increased safety by two –stage hepatectomy with preoperative portal vein embolization in rats. J Surg Res 1994;57:687-92
5. Yachida S, Ikeda K, Kaneda K,Goda F, Maeba T. Preventive effect of preoperative portal vein ligation on endotoxin-induced hepatic failure in hepatectomized rats is associated with reduced tumour necrosis factor Alpha production. Br J Surg 2000;87:1382-90,
6. Nakeeb A, Pitt H, Sohn T et al. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors Ann Surg 1996; 224:463-75
7. Pitt HA, Yeo JC, Dooley WC, Cameron JL. Malignancies of the biliary tree. In: Wells SA, Ed. Current Problems in Surgery. 6th ed. New York. Mosby A Times Mirror Company 1995;32:1-90
8. Nagasue N, Yukaya H, Ogawa Y, Konho H, Makamura T. Human liver regeneration after major hepatic resection. Ann Surg 1987;206:30-9
9. Boerma EJ. Research into the results of resection of hilar bile duct cancer. Surgery 1990; 108:572-80
10. Rozga J, Jeppsson B , Bengmark S. Hepatotrophic factors in liver growth and atrophy Br J Exp Path 1985;66: 669-78
11. Rozga J, Jeppsson B , Bengmark S. The effect of pancreatic and intestinal venous blood on hepatic atrophy and compensatory hyperplasia in the rat. Acta Physiol Pol 1988;39:5-6
12. Kawasaki S, Makuuchi M, Miyagama S, Kakazu T. Radical operation after portal embolization for tumor of hilar bile duct. J Am Coll Surg 1994;178:480-86
13. Nagino M, Nimura Y, Kamiya J. Portal vein embolization: utility for inducing left hepatic lobe hypertrophy before surgery. Hepatology 1995;21:434-9
14. Schweizer W, Duda P, Tanner S, Balsiger D, Blumgart LH, Zimmermann A. Experimental atrophy/hypertrophy complex (ACH) of liver: Portal vein, but not bile duct obstruction, is the main driving force for the development of AHC in the rat. J Hepatol 1995;23:71-8
15. Alison MR, Ryan CJ, Lee CA et al. Compensatory hyperplasia in rat liver as a result of cytoplasmic atrophy. Br J Exp Path 1986;67:901-8
16. Rous P, Larimore LD. Relation of the portal blood to liver maintance: A demonstration of liver atrophy conditional on compensation. J Exp Med 1920;31: 609-32
17. Honjo I, Suzuki T, Ozawa K, Takasan H. .Ligation of a branch of the portal vein for carcinoma of liver. Am J Surg 1975;130: 296-302
18. Kwon A H, Inada Y, Uetsuji S. Response of fibronectin to liver regeneration after hepatectomy. Hepatol 1990;11:593-7 19. Higgins GM, Anderson RM. Experimental pathology of the liver. Arch Pathol 1931;12:186-202
20. Fausto N, Mead JE. Biology of disease. Laboratory Investýgation 1989;60:4-11 21. Rozga J, Jeppsson B , Bengmark S. Hepatotrophic factors in liver growth and atrophy. Br J Exp Path 1985;66:669-78
22. Alison MR. Regulation of hepatic growth. Physiol Rev 1986;66:499-541
23. Sekas G, Owen WG, Cook RT. Fractionation and preliminary characterization of a low molecular weight bovine hepatic inhibitör of DNA synthesis in regenerating rat liver. Exp Cell Res 1979;122:47-54
24. McMahon JB, Farrelly JG, Iype PT. Purification and properties of a rat liver protein that specifically inhibits the proliferation of nonmalignant epithelial cells from rat liver. Proc Natl Acad Sci 1984:79;456-90
25. SakPfeffermann R, Kountz SL. On the origin of the regeneration factor. Surgery 1977; 145:889-94
26. Frederick L, Moolten N L, Bucher R. Regeneration of rat liver: Transfer of humoral agent by cross circulation. Science 1967;10:272-4
27. Tanaka Y, Mak K, Lieber CS. Immumohistochemical detection of proliferating lipocytes in regenerating rat liver. J Pathalogy 1990;160:129-34
28. Um S, Nishida O, Tokubayashi M et al. Hemodynamic changes after ligation of a major branch of the portal vein in rats. comparison with rats with portal vein constriction. Hepatol 1994;19:202-9
29. Sarac TP, Sax HC, Doerr R,Yuksel U, Pulli R, Caruana J. Preoperative fasting improves survival after 90% hepatectomy. Arch Surg 1994;129:729-30
30. Chijiwa K, kameoka N, Saeki S et al. Functional contribution of preoperative portal vein occlusion to hepatectomy with special reference to hepatic energy charge and DNA synthesis after hepatectomy in rats. Arch Surg 1996;131:779-84
31. Daniel PM, Prichard NML. Variations in the circulation of the portal venous blood within the liver. J Physiol 1951;114:521- 37
32. Gaub J, Iverson J. Rat liver regeneration after 90% partial hepatectomy. Hepatol 1984;4:902-4
33. Adkison D, Hollwarth ME, Benoit JN, Parks DA, McCord JM, Granger DN. Role of free radicals in ischemia-reperfusion injury to the liver. Acta Physiol Scand 1986;548(suppl):101-7