Associating Liver Partition and Portal Vein Occlusion, Including Venous Congestion, Induction in Rats

Anticancer Res. 2017 Jun;37(6):2919-2925. doi: 10.21873/anticanres.11645.

Abstract

Background/aim: Associating liver partition with portal vein occlusion for staged hepatectomy (ALPPS) is a recently developed strategy for inducing rapid hypertrophy of the future liver remnant (FLR). To explore possible mechanisms, we designed the first model of ALPPS with venous congestion (ALPPS+C) in rats.

Materials and methods: Rats were assigned randomly to 3 experimental groups: ALPPS, ALPPS+C and sham. Hepatic regeneration rate, Ki-67 and histopathology were assessed at 24 h, 48 h, and 7 days postoperatively.

Results: Hepatic regeneration rate was much higher for ALPPS+C than for ALPPS at 48 h and 7 days postoperatively (p<0.01). Microscopically, the regenerating liver showed greater hepatocyte density and smaller hepatocyte size in ALPPS+C than in ALPPS (p<0.01 for each).

Conclusion: Greater hepatic regeneration in ALPPS+C than in ALPPS confirmed that we established a rat model of ALPPS with benefit from venous congestion. Producing a congested area may contribute importantly to rapid FLR hypertrophy during ALPPS.

Keywords: ALPPS; congestion; hepatectomy; liver regeneration; portal vein occlusion; rats.

MeSH terms

  • Animals
  • Hepatectomy / methods*
  • Interleukin-6 / genetics
  • Liver / metabolism
  • Liver / pathology
  • Liver / surgery*
  • Liver Regeneration* / genetics
  • Male
  • Portal Vein / pathology*
  • RNA, Messenger / metabolism
  • Rats, Wistar
  • Tumor Necrosis Factor-alpha / genetics

Substances

  • Interleukin-6
  • RNA, Messenger
  • Tumor Necrosis Factor-alpha