The effect of silymarin given before partial hepatectomy on liver regeneration in rats with ischemic preconditioning during liver resection

Abstract

Background: The regeneration capacity of liver tissue after partial hepatectomy closely affects morbidity and mortality. We aimed to investigate the effect of silymarin and ischemic preconditioning (IPC) before partial hepatectomy on liver regeneration.Methods: Thirty rats were randomly divided into 5 groups (n=6). Serum AST, bilirubin, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) values were studied 48 hours after hepatectomies. Mitotic count, congestion, necrosis, cytoplasmic vacuolization, and presence of neutrophils were evaluated histopathologically. Proliferating cell nuclear antigen (PCNA) antibody was studied immunohistochemically.Results: The AST value (2071.5±938.4) was the highest in the partial hepatectomy (PH) group. The Ischemic Preconditioning Partial Hepatectomy Group (IPC) (1535.5±204.8) and the Silymarin+Partial Hepatectomy Group (Silymarin group) (1192.3±526.3) had lower levels of AST values; however, the AST values were the lowest in the Silymarin+Ischemic Preconditioning+ Partial Hepatectomy Group (IPC+ Silymarin group) (1002.8±348.9). Likewise, the highest improvement in bilirubin levels was observed in the IPC+ Silymarin group (0.33±0.11). IL-6 (11.54±2.89) and TNF-α (39.2±22.73) values were the lowest in the IPC group, and interestingly, both were higher in the silymarin-treated groups. It was observed that these values increased in Silymarin group and IPC+ Silymarin group who received silymarin treatment compared to PH group and IPC group who did not receive silymarin. In histopathological analysis, it was found that the mitosis rate and PCNA percentage were higher in the Silymarin and IPC+ Silymarin groups.Conclusions: The use of silymarin before hepatectomy and IPC during partial hepatectomy increase liver regeneration.