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PubMedDate not supplied

Differences in biliary lipid excretion after major hepatectomy in obstructive jaundiced rats with preoperative internal, external, or no biliary drainage.

Necessity of preoperative biliary drainage for patients with obstructive jaundice is still controversial. We recently reported that liver regeneration after major hepatectomy was better restored in a rat model of obstructive jaundice with preoperative internal biliary drainage than that without biliary drainage or with external biliary drainage. The aim of this study was to investigate the differences in biliary lipid excretion after hepatectomy in obstructive jaundiced rats with or without preoperative internal or external biliary drainage. After bile duct ligation for 7 days, rats were randomly divided into the three groups; obstructive jaundice-hepatectomy (OJ-Hx), internal biliary drainage-hepatectomy (ID-Hx), and external biliary drainage-hepatectomy (ED-Hx) groups. 70% hepatectomy and internal biliary drainage were carried out 7 days after biliary decompression in the latter two groups and without biliary decompression in the OJ-Hx group. On the day of and on days 1, 2, 3 and 7 after hepatectomy, the liver weight, DNA synthesis rate, biliary lipids excretion rates, and bile acid composition were determined. In the ID-Hx group, the DNA synthesis rate and relative liver weight were significantly higher than those of the OJ-Hx and ED-Hx groups. The excretion rates of biliary lipids were disturbed in the ED-Hx group compared with those in the ID-Hx group and the values in the OJ-Hx group were in-between the ID-Hx and ED-Hx group. The liver regeneration rate was significantly correlated with bile flow and excretion rates of biliary lipids. The maintenance of enterohepatic circulation of biliary lipids before hepatectomy may be important for the liver regeneration.

Animals↗
PubMed1983

Alteration in the inducibility by dexamethasone of the activity of tyrosine aminotransferase and tryptophan oxygenase in regenerating rat liver after partial hepatectomy.

In adrenalectomized rats, the activity of tryptophan oxygenase in liver cytosol was increased 4 h after dexamethasone injection, with a peak on day 2. It then gradually decreased to the value obtained in normal animals treated with dexamethasone. In adrenalectomized, 70% hepatectomized rats, tryptophan oxygenase activity decreased significantly during the period of DNA synthesis after partial hepatectomy; it then increased to above the level existing before hepatectomy, reaching a maximum on day 5, and subsequently returned to the level before hepatectomy. These changes were well correlated with those of dexamethasone receptors at all times after adrenalectomy and partial hepatectomy. In adrenalectomized rats, tyrosine aminotransferase activity was increased 4 h after dexamethasone injection, reached a maximum on day 2, and then remained elevated. The level was increased by subsequent 70% hepatectomy, reached a maximum on day 5, and then began to decrease, but activity was still high on day 10 after hepatectomy when the receptor level had returned to the value existing before hepatectomy. When actinomycin D or cycloheximide was injected with dexamethasone, the induction of the two enzymes was completely inhibited. The activities of the two enzymes in regenerating liver of rats without adrenals and without glucocorticoid treatment were as low as those in adrenalectomized rats without glucocorticoid treatment. Thus, there was a good correlation between the dexamethasone receptor level and the induction of tryptophan oxygenase, but there was a dissociation between the receptor level and the induction of tyrosine aminotransferase after adrenalectomy and partial hepatectomy. The mechanism of this dissociation is unknown.

Adrenalectomy↗
PubMed1992

Growth hormone promotes early initiation of hepatocyte growth factor gene expression in the liver of hypophysectomized rats after partial hepatectomy.

GH accelerates hepatic regeneration in the rat. Hepatocyte growth factor (HGF), a potent hepatocyte mitogen in vitro, is considered to be a major regulator of hepatic regeneration. In the present study, the effects of GH and insulin-like growth factor-I (IGF-I) on HGF gene expression in regenerating rat liver was investigated. In hypophysectomized rats treated with GH, hepatic HGF mRNA levels were increased 3 h after partial hepatectomy and reached peak levels after 5 h. In rats with intact pituitaries and in hypophysectomized rats not given GH treatment, HGF mRNA levels in liver were unchanged during the first 5 h following hepatectomy and reached peak levels after 10-18 h. DNA synthesis in the liver of GH-treated rats increased from low levels 10 h after hepatectomy to peak levels after 18 h. In rats without GH treatment the synthesis of DNA was still low 18 h after hepatectomy and was increased after 26 h. Treatment of hypophysectomized rats with IGF-I promoted increases in hepatic HGF mRNA levels and DNA synthesis 3.5 h and 15 h after hepatectomy respectively. HGF mRNA levels were constantly lower after sham-hepatectomy than after partial hepatectomy. In summary, in hypophysectomized rats the responses of hepatic HGF gene expression and DNA synthesis to partial hepatectomy were both accelerated by treatment with GH or IGF-I.

Animals↗
PubMed1993

Rapid clearance of insulin-like growth factor (IGF)-binding protein species from blood and an associated fall in circulating IGF-I following partial hepatectomy in the rat.

The presence of insulin-like growth factors (IGFs) in blood is regulated by their association with specific IGF-binding proteins (IGFBPs). In turn, the level of IGFBPs in the blood is likely to depend on a dynamic equilibrium between peptide production and clearance to extravascular tissues or organ-specific degradation. Since circulating IGFBPs may largely derive from liver we have employed partial hepatectomy in the rat to study the clearance rate of endogenous IGFBPs from blood once a major site of production is removed. Adult male rats were partially hepatectomized and serum and the remaining liver removed between 30 min and 7 days after surgery. Ligand blot analysis revealed two major species of IGFBP, of 28-30 kDa and 40-44 kDa in sera from control rats or sham-operated rats respectively. The larger species corresponded in size to rat IGFBP-3, but the smaller form was not recognized by antisera against rat IGFBP-1, bovine IGFBP-2 or human IGFBP-5 following Western immunoblot. Following hepatectomy, the levels of both IGFBP forms in the serum declined within 30 min and were barely detectable after 3 h or 6 h. They began to increase again in serum 24 h following surgery. The reduction in IGFBPs following hepatectomy was not primarily due to degradation by specific proteases in serum. Circulating levels of insulin were increased fivefold 3 h after hepatectomy but subsequently returned to control values. The rise in insulin was accompanied by a significant (P < 0.05) reduction in circulating IGF-I after 3 h which persisted at 24 h. Glucose levels in serum showed a transient but non-significant reduction between 90 min and 6 h after hepatectomy. Total RNA was extracted from remnant liver and subjected to Northern blot hybridization with 32P-labelled cDNAs encoding rat IGFBP-1, -2 or -3. Messenger RNA encoding IGFBP-1 was barely detectable in liver from control or sham-operated animals, but increased within 30 min of partial hepatectomy and peaked at 3 h. It subsequently declined and was again barely detectable after 24 h. No expression of IGFBP-2 or -3 mRNAs was found by Northern blot analysis in the liver of control animals or following partial hepatectomy. These results suggest that both IGF-I and IGFBPs in rat serum decreased rapidly following partial hepatectomy, and that this was due largely to the rapid clearance of the peptide and its binding proteins once the major source of production was removed.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMedDate not supplied

Ultrastructural study of the remnant liver after extensive hepatectomy in dogs; especially morphological alterations of sinusoidal endothelial cells.

BACKGROUND/AIMS: To investigate the role of sinusoidal endothelial cells in the mechanism of the remnant liver dysfunction after extensive hepatectomy, morphological alteration of sinusoidal endothelial cells and cytoprotective effects of prostaglandin I2 analog were studied by ultrastructural analysis. METHODOLOGY: Mongrel dogs (n = 24) were divided into 3 groups according to the extent of hepatectomy and the use of prostaglandin I2 analog preoperatively. Group 1: 70% hepatectomy (n = 8), Group 2: 84% hepatectomy (n = 8), and Group 3: 84% hepatectomy with administration of prostaglandin I2 analog, preoperatively (n = 8). Morphology of hepatic sinusoidal endothelial cells was examined after hepatectomy in all cases. RESULTS: Group 2: Enlargement of the sinusoidal endothelial fenestrations was transitorily occurred immediately after hepatectomy, but were dramatically decreased in size 24 h after the operation. Most sinusoidal endothelial cells were destroyed and separated from the sinusoidal wall. Fibrin deposits and sludge were found in the Disse's space and sinusoidal lumens, resembling liver failure at 24 h after the operation. Group 1 and 3: sinusoidal endothelial fenestrations remained slightly enlarged at 24 h after the operation, but fibrin deposits or sludge were not observed in sinusoidal lumens. CONCLUSIONS: Our data suggest that extensive hepatectomy changed the morphology of sinusoidal endothelial cells. Administration of prostaglandin I2 analog helped maintain structural integrity of sinusoidal endothelial cells, improved hepatic microcirculation and thus served to reduce remnant liver dysfunction.

Animals↗
PubMedDate not supplied

Effects of streptococcal preparation OK-432 on liver regeneration and energy status after partial hepatectomy under ischemia/reperfusion in rats.

BACKGROUND/AIMS: Activation of reticuloendothelial system functions by the treatment with OK-432 has been reported to enhance liver regeneration. However, its effect on liver regeneration has not been studied after hepatectomy under ischemia/reperfusion which is in clinical use. The aim was to examine the effect of OK-432 on regeneration and energy status of the liver after hepatectomy under ischemia/reperfusion in rats. METHODOLOGY: Rats were randomly divided into two groups; OK-432 pretreatment and saline treatment (control) group. In the OK-432 group, OK-432 (2.5 mg/kg body weight) was administered intraperitoneally 24 hours before hepatectomy. In the control group, the same volume of physiological saline was administered in the same manner. Seventy percent hepatectomy was performed in both groups during the second 15-minute ischemia period after an initial 15-minute ischemia and 15-minute reperfusion periods. The survival after hepatectomy, relative liver weight, deoxyribonucleic acid synthesis rate, and hepatic adenine nucleotide and energy charge levels were examined immediately after hepatectomy and on postoperative days 1, 2, 3, and 7. Serum levels of total bilirubin, glutamic pyruvic transaminase, and hyaluronic acid were also measured. RESULTS: All rats survived and the relative liver weight and deoxyribonucleic acid synthesis rate were not significantly different in the two groups. Serum total bilirubin and glutamic pyruvic transaminase levels were not significantly different in both groups. The serum concentration of hyaluronic acid immediately after hepatectomy was significantly higher in the OK-432 group than in the control group. The pretreatment with OK-432 had no significant effect on the levels of adenine nucleotides and energy charge in the liver. CONCLUSIONS: Under ischemia/reperfusion, pretreatment with OK-432 has no significant effect on regeneration and energy status of the liver after hepatectomy.

Adenine Nucleotides↗
PubMedDate not supplied

Effects of portal vein embolization before major hepatectomy.

BACKGROUND/AIMS: Major hepatectomy can now be successfully performed after portal vein embolization, but the effects of portal vein embolization have not been clearly delineated. Our objective is to examine whether portal vein embolization really contributes to the success of major hepatectomy. METHODOLOGY: Thirty-eight patients underwent portal vein embolization and hepatectomy of two subsegments or more. They all belonged to a high-risk group according to a prognostic score. We selected 9 of 38 patients with liver metastases (PE-meta group) and 32 patients who had undergone hepatectomy without portal vein embolization (non-PE-meta group) during the study period to compare the serum levels of total bilirubin after hepatectomy. Fifteen of 38 patients had the levels of polymorphonuclear leukocyte elastase and thrombin-antithrombin complex examined after hepatectomy (PE group) and so did 20 patients without portal vein embolization (non-PE group). RESULTS: The maximum levels of total bilirubin in non-PE-meta group correlated with the percentage of hepatic parenchyma to be resected. In the patients receiving portal vein embolization, the pre-PE and post-PE levels were both below the regression. Similar shifts were seen in the graphs of polymorphonuclear leukocyte elastase and thrombin-antithrombin complex. CONCLUSIONS: The effects of preoperative portal vein embolization on safety in major hepatectomy were proved by its suppression of rise in total bilirubin, polymorphonuclear leukocyte elastase and thrombin-antithrombin complex after hepatectomy.

Aged↗
PubMedDate not supplied

Serum 7alpha-hydroxycholesterol levels during liver regeneration after hepatectomy in humans.

BACKGROUND/AIMS: Changes in bile acid synthesis during liver regeneration after hepatectomy is little known in humans. Since it has been reported that the serum 7 alpha-hydroxycholesterol levels reflect the hepatic bile acid synthesis and that the determination of bile acid synthesis is useful to assess the liver regeneration rate, we determined the serum 7 alpha-hydroxycholesterol level during liver regeneration after hepatectomy in clinical patients. METHODOLOGY: The serum 7 alpha-hydroxycholesterol levels were determined by gas-liquid chromatography-mass spectrometry-selected ion monitoring method before and on days 1, 3, 5, 7, 14 and 21 after hepatectomy in twenty consecutive patients. RESULTS: The 7 alpha-hydroxycholesterol levels became lower between days 1 and 7, were increased on day 14, and then decreased on day 21 after hepatectomy. The patients with preoperative external biliary drainage showed a higher serum 7 alpha-hydroxycholesterol level than those without biliary drainage before hepatectomy. The former showed lower serum 7 alpha-hydroxycholesterol levels than the latter throughout the 21 days after hepatectomy. In patients whose liver resection rate was more than 50%, the serum 7 alpha-hydroxycholesterol levels were kept lower until 21 days after hepatectomy compared with those whose liver was excised less than 50%. CONCLUSIONS: It is concluded that the patients who had preoperative biliary drainage or major hepatic resection seem to have less hepatic reserve capacity for bile acid synthesis after hepatectomy.

Bile Acids and Salts↗
PubMedDate not supplied

Hanging maneuver in left hepatectomy.

The liver hanging maneuver in right hepatectomy introduced by Belghiti in 2001, is a safe and effective method for right hepatectomy in cases of large hepatoma and living donor liver transplantation. In this article, we first introduce the hanging maneuver in extended left hepatectomy (left hepatectomy including middle hepatic vein). Extended left hepatectomy is a more difficult procedure than right hepatectomy because in the deeper part of the transection, the plane sharply turns to the left above the caudate lobe. Using the hanging maneuver, the horizontal transection plane becomes vertical, and the extended left hepatectomy can be performed easier and safer. This technique can be applied effectively in all kinds of left-sided hepatectomies.

Blood Loss, Surgical↗
PubMed2004

Near-infrared spectroscopic analysis of hepatic hemodynamics and oxygen metabolism after extensive hepatectomy.

BACKGROUND: Although major or extended hepatectomy may result in drastic alterations in the hemodynamics and oxygen metabolism of the residual livers, this issue remains to be elucidated in detail. MATERIAL/METHODS: In this study, in vivo near-infrared spectroscopy (NIRs) was performed to determine oxy-/deoxy-hemoglobin (Hb) and oxidized/reduced cytochrome oxidase (Cyt.aa3) contents in hepatic tissues in a rat 70% hepatectomy model. We also investigated the effectiveness of Pringle occlusion for minimizing bleeding and the therapeutic effects of prostaglandin E1 (PGE1) on haemodynamics alteration after hepatectomy. RESULTS: After 70% hepatectomy, total Hb (oxy-Hb + deoxy-Hb) content was persistently elevated in the residual hepatic tissues, indicating congestion probably caused by surplus portal inflow. Oxidized Cyt.aa3 contents were elevated after hepatectomy, whereas reduced Cyt.aa3 contents were not significantly altered, indicating that mitochondrial respiration was not impaired. Pringle occlusion before hepatectomy per se did not cause deterioration of the hemodynamics or oxygen metabolism of the residual livers. The congestion of the residual liver after 70% hepatectomy was significantly improved by continuous injection of PGE1 (1.0 mg/kg/min) via the portal vein. CONCLUSIONS: The alteration of hemodynamics and oxygen metabolism in the liver after extended hepatectomy has been quantitatively evaluated using the NIRs.

Animals↗
PubMed1991

Effect of hyperdynamic circulatory support on hepatic hemodynamics, oxygen supply and demand after massive hepatectomy.

This study was designed to clarify the effect of hyperdynamic circulatory support with dobutamine or dopamine after massive hepatectomy on hepatic hemodynamics, oxygen supply and demand, and lactate uptake. Mongrel dogs were allocated three groups: 70% hepatectomy group; a group that received dobutamine after 70% hepatectomy; and a group that received dopamine after 70% hepatectomy. Hepatic blood flow and oxygen delivery to the liver decreased after 70% hepatectomy. Although oxygen consumption in the liver also decreased, oxygen consumption per liver weight increased after massive hepatectomy; an increase of oxygen uptake ratio and a decrease of lactate uptake in the liver were observed. When dobutamine or dopamine were administered after 70% hepatectomy, hepatic blood flow increased, followed by normalization of the balance of oxygen supply and demand in the liver; lactate uptake subsequently improved in the liver. The data support the conclusion that hepatic oxygen consumption affected by dopamine and dobutamine is associated with an increase in the extraction of lactate. Hyperdynamic hepatic circulatory support was advantageous to hemodynamics and metabolism in the residual liver after massive hepatectomy.

Animals↗
PubMed1989

[Evaluation of hepatic gluconeogenesis by intravenous L-alanine tolerance test after major hepatectomy].

The response of glucose, insulin and glucagon to L-alanine tolerance test (0.5 g/kg, intravenously, A.T.T.) was examined in dogs following hepatectomy. Before A.T.T., dogs were starved for 24 hours after antecedent carbohydrate-free diets. Under this condition, hepatic glycogen and blood glucose were 0.5 +/- 0.2 mg/g liver and 85 +/- 11.9 mg/dl, respectively. The marked response of blood glucose to alanine tolerance test was observed and the maximal increment above the basal level was 47 +/- 5.2 mg/dl at 30 minutes after A.T.T. One week after 44% and 70% hepatectomy, the increments of glucose at 30 minutes after A.T.T. were 58% and 24% respectively, as compared with those before hepatectomy. These results suggest that the glucose response to alanine tolerance is useful for an index of functional reserve of glucose production in the remnant liver after hepatectomy. The increments of blood glucose at 30 minutes after A.T.T. 1, 2, 3 and 4 weeks after 70% hepatectomy were 24.0, 21.8, 52.7 and 80% of that before hepatectomy respectively. The insulin response to alanine tolerance gave two peaks at 2.5 min and 30 min and the latter peak was dependent on the blood glucose response before and after hepatectomy. One or two weeks after 70% hepatectomy, the exaggerated glucagon response to alanine tolerance was observed. These results suggest that A.T.T. is not only an excellent index of functional reserve of hepatic gluconeogenesis, but also is an appropriate method for investigation of the relation between endogenous glucose production and endocrine pancreas.

Alanine↗
PubMed1988

[Changes of gluconeogenesis and alanine metabolism following partial hepatectomy in normal and cirrhotic rats].

Gluconeogenesis and alanine metabolism of normal and cirrhotic rats were studied in view of partial hepatectomy. Liver cirrhosis was made by repeated injection of thioacetamide in rat. Partial hepatectomy was performed by modified method of Higgins-Anderson. Liver glycogen and fructose-2, 6-bisphosphate were decreased after hepatectomy and recovered within 7 days in normal groups, while those of cirrhotic group reduced even in preoperative state were further decreased and hardly recovered after hepatectomy. Gluconeogenesis of perfused liver in cirrhosis was increased from both lactate and alanine preoperatively, but gluconeogenesis from alanine was not increased in both hepatectomized rats. ATP and energy charge were decreased after hepatectomy and recovered within two weeks. These level were lower in cirrhotic group, and decreased further and hardly recovered after hepatectomy. Alanine utilization to CO2 in vivo was not impaired in cirrhotic group either preoperatively or postoperatively. ATP and energy charge were increased by alanine injection in hepatectomized rats of both normal and cirrhotic group. In conclusion, glucose-insulin therapy of sufficient amounts is important to improve decreased glycolysis and abnormal gluconeogenesis on both post-hepatectomy period of normal and pre and post-hepatectomy period of cirrhosis. Also alanine is effective for stimulating decreased energy production.

Alanine↗
PubMed1987

[Efficacy of vagotomy on liver regeneration in the prevention of stress ulcer after partial hepatectomy in the cirrhotic rat].

Possible effects of vagotomy (a means of preventing stress ulcers after partial hepatectomy in cirrhotic liver) on liver regeneration were explored. Cirrhosis was induced in rats by means of intraperitoneally administering 4% thioacetamide for 10 consecutive weeks. These rats were subjected to partial hepatectomy (ca. 68% resection) and vagotomy at the same time. Normal rats of consistent age served as controls after receiving hepatectomy. In controls, which received hepatectomy alone, both gastric pH and gastric wall blood flow showed a significant reduction on the third day after surgery. In animals which received both hepatectomy and vagotomy, postoperative reduction in gastric pH was suppressed, but postoperative reduction in gastric wall blood flow was more marked compared to those of controls. In animals which received both hepatectomy and vagotomy, postoperative 3H-thymidine intake and thymidine kinase activity were markedly suppressed compared to controls. In animals which received both hepatectomy and vagotomy, the peak level of mitotic index and the hepatic regeneration rate were markedly suppressed compared to those of controls. The above results indicate that vagotomy is not advantageous to liver regeneration and prevention of stress ulcer after partial hepatectomy in cirrhotic rat because of its potency of inducing marked reduction in gastric wall blood flow and impediment of liver regeneration.

Animals↗
PubMed1986

[Experimental study on efficacy of cimetidine and 16,16-dm PGE2 to liver regeneration in prevention of stress ulcer after partial hepatectomy in the cirrhotic rat].

Stress ulcer is a common phenomenon after hepatectomy for cirrhotic liver. We examined experimentally the influence of cimetidine and 16,16-dm PGE2 dosaged as counter-measures against stress ulcer on liver regeneration after partial hepatectomy for cirrhotic liver. Using cimetidine and 16,16-dm PGE2, there was a noticeable suppression of the onset of water immersion stress ulcer, and both a decline in the blood flow in the wall of the stomach and a drop in PH in the stomach were inhibited after partial hepatectomy for cirrhotic liver. The group given 16,16-dm PGE2 after partial hepatectomy had a higher rate of DNA synthesis as compared with the group which had only partial hepatectomy. No difference was seen between the group given cimetidine and the only partial hepatectomy groups. The group given indomethacin before partial hepatectomy for cirrhotic liver had a noticeable decrease in mitotic index 30 hours after partial hepatectomy. However, the group given both indomethacin and 16,16-dm pGE2, showed some recovery of the mitotic index.

16,16-Dimethylprostaglandin E2↗
PubMed1994

The regeneration of cirrhotic liver after partial hepatectomy: a study using the rat carbon tetrachloride-induced cirrhotic model.

There are conflicting data regarding the ability of the liver to regenerate after partial hepatectomy in animals and humans with cirrhosis. The purpose of this study was to document liver regeneration after partial hepatectomy in a carbon tetrachloride rat model of cirrhosis. Liver cirrhosis was produced by weekly intragastric gavage with carbon tetrachloride in 80 adult male rats. Vehicle-gavaged rats (n = 24) served as healthy controls. Liver regeneration was documented 1, 2, 3 and 7 days after partial hepatectomy on the basis of restitution of liver mass and [3H] thymidine incorporation into liver DNA. Restitution of liver mass after partial hepatectomy was significantly decreased in carbon tetrachloride-treated rats at 1 and 7 days compared with the vehicle-treated control rats. In cirrhotic rats, restitution of liver mass at 1, 2, 3 and 7 days did not differ between 33% and 70% hepatectomy. Hepatic DNA synthesis, however, was significantly impaired at 1 and 2 days in cirrhotic rats after 70% hepatectomy and also at 1 day after 33% hepatectomy compared with non-cirrhotic rats. The results of this study indicated that live regeneration did occur after partial hepatectomy in carbon tetrachloride-treated rats but was impaired in comparison with that in vehicle-treated control rats.

Animals↗
PubMed1993

[Triple hepatectomy for cancer].

The resection of the metastases from digestive malignant lesions are always the most efficient treatment, if it is complete. However it must be performed without major operative risk. According to this point of view, it is logical to examine the feasibility of three successive hepatectomies for metastases. We report in this study our experience with five cases of triple hepatectomies performed for 4 colic cancers and 1 carcinoid cancer. Two major hepatectomies were performed during this third resection. The re-exposure of the liver was very difficult in 4 cases, and the texture of the liver parenchyma was flabby and abnormal in 5 cases (confirmed with the histologic study). The mean duration of the surgery was 307 minutes, the mean duration of the intermittent pedicle clamping was 59 minutes, and the mean blood loss was 1710 ml. No post-operative death occurred, and the morbidity was low. This 5 third hepatectomies have been compared, for the feasability, to the 41 second hepatectomies and to the 234 first hepatectomies which we have performed. In proportion as hepatectomies are carried out, the difficulties to expose the liver increase, the texture of the liver parenchyma gets spoiled and the duration of the operation increases. In conclusion, the third hepatectomies are technically difficult to perform, but they are feasable. However it is too early to be able to define their indications.

Adenocarcinoma↗
PubMedDate not supplied

The role of prostanoid in hepatic damage during hepatectomy.

BACKGROUND/AIMS: The aim of this study in hepatectomy is to investigate whether or not hepatic ischemia elevates the serum prostanoid levels, and whether or not thromboxane A2 (TXA2) synthetase inhibitor (OKY 046) improves hepatic damage. MATERIALS AND METHODS: The prostanoid levels were measured in 22 hepatectomy cases. The beneficial effects of thromboxane A2 synthetase inhibitor were examined in cases who underwent hepatectomy under hemihepatic vascular control. The total prostanoid levels (6-keto PG Fla+ PGE2 + TXB2) were measured in 22 cases before and after hepatectomy. The hepatic ischemic time (HIT) was defined as the time required to perform a hepatic mobilization plus the right hemihepatic vascular control technique. RESULTS: The total prostanoid levels increased after hepatectomy (P < 0.01). The changes in the total prostanoid levels positively correlated with the HIT (P < 0.01). The 17 cases who underwent hepatectomy with the HIT were randomly divided into 2 groups; the OKY group (n = 9), OKY 046 (0.2 mg/kg/hr), the control group (n = 8); no drug was given. The OKY 046 administration reduced the TXB2 levels (P < 0.01), without any changes in the PGE2, or 6-keto PGF1a levels. The serum glutamic oxaloacetic transaminase levels after operation were lower, and the hepaplastin tests were higher in the OKY group than those of the control (P < 0.05). CONCLUSION: These results demonstrated that hepatectomy under ischemia elevated the prostanoid levels. OKY 046 significantly reduced the TXB2 levels and the degree of hepatic damage in hepatectomy under ischemia.

Aspartate Aminotransferases↗