Beneficial effects of arterialization of the portal vein on extended hepatectomy

Author:

Shimizu Y1,Miyazaki M1,Shimizu H1,Ito H1,Nakagawa K1,Ambiru S1,Yoshidome H1,Nakajima N1

Affiliation:

1. First Department of Surgery, School of Medicine, Chiba University, 1–8–1 Inohana, Chuo-ku, Chiba 260–0856, Japan

Abstract

Abstract Background Extended hepatectomy may result in postoperative liver failure. The aim of this study was to evaluate the effects of arterialization of the portal vein on oxygen supply, hepatic energy metabolism and liver regeneration after extended hepatectomy. Methods Portal haemodynamics were evaluated 0 or 10 days after arterialization of the portal vein in three experimental groups: 85 per cent partial hepatectomy, 85 per cent partial hepatectomy 10 days after arterialization of the portal vein and 85 per cent partial hepatectomy 10 days after ligation of the hepatic artery. Survival rates, weight of the regenerating liver, levels of adenine nucleotides and hepatic energy charge were assessed. Results Arterialization of the portal vein caused a significant increase in partial pressure of oxygen and oxygen saturation. Portal blood flow 10 days after arterialization was significantly increased. Survival rate and weight of the regenerating liver in the group with arterialization of the portal vein were significantly higher than those in the other two groups. The group with arterialization of the portal vein showed the highest levels of adenosine 5′-triphosphate. Conclusion The increase in portal blood flow and oxygen supply produced by arterialization of the portal vein has beneficial effects on hepatic energy metabolism and liver regeneration, and leads to improved survival after experimental extended hepatectomy.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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