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Functional Contribution of Preoperative Portal Vein Occlusion to Hepatectomy With Special Reference to Hepatic Energy Charge and DNA Synthesis After Hepatectomy in Rats

Kazuo Chijiiwa, MD; Nobuhisa Kameoka, MD; Shuji Saeki, MD; Mikio Komura, MD; Koji Yamaguchi, MD; Syoji Kuroki, MD; Masao Tanaka, MD
Arch Surg. 1996;131(7):779-784. doi:10.1001/archsurg.1996.01430190101025.
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Objective:  To examine possible functional contributions of preoperative portal branch ligation before hepatectomy (PBL-Hx).

Design:  Rats were randomly divided into 3 groups. In the PBL-Hx group, the portal branch supplying the left lateral and median lobes of the liver was ligated and the corresponding lobes (48% of the whole liver) were excised 2 days later. In the sham groups (one 68% Hx; the other 47% [hereafter, sham–67% Hx, and sham–47% Hx]), originally ligated lobes and left lateral and caudate lobes, similar to the excised liver volume in the PBL-Hx group, respectively, were excised 2 days after sham operation without PBL.

Main Outcome Measures:  Hepatic adenine nucleotides and energy charge, which are essential for vital function of hepatocytes, and liver regeneration were assessed by the DNA synthesis rate and weight before Hx and on days 1, 2, 3, and 7 after Hx.

Results:  The remaining liver weight was restored similarly in the PBL-Hx and sham–47% Hx groups and more rapidly than in the sham–68% Hx group. Further enhancement of DNA synthesis did not occur after Hx in the PBL-Hx group, and hepatic energy charge did not decrease. In contrast, hepatic DNA synthesis was significantly activated depending on the excised liver volume in both the sham-Hx groups and was accompanied by corresponding decreases in hepatic energy charge.

Conclusion:  Preoperative PBL has a functional advantage because the recovery of the remaining liver volume is not impaired and hepatic energy charge is preserved with no further enhancement of DNA synthesis after Hx.Arch Surg. 1996;131:779-784


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