BACKGROUND: Liver revascularization is frequently required during the enlarged radical operation for hilar cholangio carcinoma involving the hepatic artery. Researchers have carried out a number of experiments applyin...BACKGROUND: Liver revascularization is frequently required during the enlarged radical operation for hilar cholangio carcinoma involving the hepatic artery. Researchers have carried out a number of experiments applying partial porta vein arterialization (PVA) in clinical practice. In this study we aimed to establish a theoretical basis for clinical application o partial PVA and to investigate the effects of partial PVA on ra hilar bile duct and hepatic functions. METHODS: Thirty rats were randomly and equally assigned into 3 groups: control (group A), hepatic artery ligation+bile duct recanalization (group B), and partial PVA+bile duc recanalization (group C). Proliferation and apoptosis o rat hilar bile duct epithelial cells, arteriolar counts of the peribiliary plexus (PBP) of the bile duct wall, changes in serum biochemistry, and pathologic changes in the bile duc were assessed 1 month after operation. RESULTS: The proliferation of hilar bile duct epithelial cells in group B was greater than in groups A and C (P<0.01). No apoptotic hilar bile duct epithelial cells were detected in any of the groups. The PBP arteriolar counts of the hilar bile duc wall were similar in groups A and C (P>0.05), but the coun was lower in group B than in group A (P<0.01). No statistically significant differences in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and albumin were found in the 3 groups. The gamma-glutamyltransferase value was higher in group B than in groups A and C (P<0.01) The hepatic tissues of groups A and C showed no significan abnormality. Chronic inflammatory changes in the hilar bile duct walls were observed only in group B. CONCLUSION: Partial PVA can restore the arterial blood supply of the hilar bile duct and significantly extenuate the injury to hilar bile duct epithelial cells resulting from hepatic artery ligation.展开更多
Background Hilar cholangiocarcinoma is a malignant tumor that is difficult to cure. The aim of this study was to observe the effects of flow-controlled partial portal vein arterializations （PPVA） on liver regenerati...Background Hilar cholangiocarcinoma is a malignant tumor that is difficult to cure. The aim of this study was to observe the effects of flow-controlled partial portal vein arterializations （PPVA） on liver regeneration after hepatectomy in minipigs with chronic obstructive jaundice. Methods Eight minipigs were made into chronic obstructive jaundice models. United semi-hepatectomy, which imitates extended radical surgery for treatment of hilar cholangiocarcinoma, was then performed. The eight minipigs were randomly divided into groups A and B （n=4 minipigs each）. PPVA was performed in Group A but not in Group B. The effects of flow-controlled PPVA on live regeneration after hepatectomy were observed for 30 days after hepatectomy. Results The portal vein PO2 at the immediate time point and on postoperative day 30 was higher in Group A （（47.33±2.43） and （48.50±4.44） mmHg） than in Group B （（35.38±4.06） and （35.55±2.55） mmHg respectively, all P 〈0.01）. The mitotic index of liver cells on postoperative days 14 and 21 was higher in Group A （12.55%±2.85% and 15.25%±1.99% respectively） than in Group B （6.85%±2.10% and 11.88%±1.15% respectively, all P 〈0.05）. The regeneration rate of residual liver on postoperative days 14 and 21 was higher in Group A （24.56%±6.15% and 70.63%±9.83% respectively） than in Group B （11.96%±5.43% and 44.92%±7.42% respectively, P 〈0.05 and P 〈0.01 respectively）.Conclusion Flow-controlled PPVA can promote liver regeneration after hepatectomy and prevent liver failure in minipigs with chronic obstructive jaundice.展开更多
In the current study, we sought to establish a novel rat model of portal vein artefialization （PVA） and evaluate its impact on liver regeneration after extended partial hepatectomy （PH）. A total of 105 Sprague-Daw...In the current study, we sought to establish a novel rat model of portal vein artefialization （PVA） and evaluate its impact on liver regeneration after extended partial hepatectomy （PH）. A total of 105 Sprague-Dawley rats were randomly assigned to three groups： 68% hepatectomy （the PH group）, portal arterialization after 68% hepatectomy （the PVA group）, and fight nephrectomy only （the control group）. Liver regeneration rate （LRR）, 5-bromo-2-deoxyuridine （BrdU） labeling index, and liver functions were assessed on postoperative day 2, 7, 14 and 28. The 28-day survival rates were compared among the three groups. The 28-day survival rates were similar in all groups （P = 0.331）, and the anastomotic patency was 100%. The LRR in the PVA group was significantly higher than that of the PH group within postoperative 14 days （P 〈 0.05）. The PVA and PH group had increased serum alanine aminotransferase levels （232 ±61 U/L and 212 ±53 U/L, respectively） compared with the control group （101 ±13 U/L） on postoperative day 2, whereas from postoperative day 7 to day 28 there were no differences among the three groups. Serum albumin values were higher after the PVA procedure within postoperative day 14, which gradually became comparable on postoperative day 28 among the three groups. The peaks of BrdU labeling index appeared on postoperative day 2 in all rats, and the PVA procedure was associated with increased BrdU labeling index from postoperative day 7 to 28. The 28-day survival of the PVA rats was comparable. Our findings demonstrate that the PVA procedure utilizing portal vein trunk-renal artery microvascular reconstruction promotes remnant liver regeneration and confers beneficial effects on maintaining and even optimizing liver function after extended partial hepatectomy in rats.展开更多
文摘BACKGROUND: Liver revascularization is frequently required during the enlarged radical operation for hilar cholangio carcinoma involving the hepatic artery. Researchers have carried out a number of experiments applying partial porta vein arterialization (PVA) in clinical practice. In this study we aimed to establish a theoretical basis for clinical application o partial PVA and to investigate the effects of partial PVA on ra hilar bile duct and hepatic functions. METHODS: Thirty rats were randomly and equally assigned into 3 groups: control (group A), hepatic artery ligation+bile duct recanalization (group B), and partial PVA+bile duc recanalization (group C). Proliferation and apoptosis o rat hilar bile duct epithelial cells, arteriolar counts of the peribiliary plexus (PBP) of the bile duct wall, changes in serum biochemistry, and pathologic changes in the bile duc were assessed 1 month after operation. RESULTS: The proliferation of hilar bile duct epithelial cells in group B was greater than in groups A and C (P<0.01). No apoptotic hilar bile duct epithelial cells were detected in any of the groups. The PBP arteriolar counts of the hilar bile duc wall were similar in groups A and C (P>0.05), but the coun was lower in group B than in group A (P<0.01). No statistically significant differences in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and albumin were found in the 3 groups. The gamma-glutamyltransferase value was higher in group B than in groups A and C (P<0.01) The hepatic tissues of groups A and C showed no significan abnormality. Chronic inflammatory changes in the hilar bile duct walls were observed only in group B. CONCLUSION: Partial PVA can restore the arterial blood supply of the hilar bile duct and significantly extenuate the injury to hilar bile duct epithelial cells resulting from hepatic artery ligation.
基金This research was supported by the National Natural Science Foundation of China （No. 81072014）.
文摘Background Hilar cholangiocarcinoma is a malignant tumor that is difficult to cure. The aim of this study was to observe the effects of flow-controlled partial portal vein arterializations （PPVA） on liver regeneration after hepatectomy in minipigs with chronic obstructive jaundice. Methods Eight minipigs were made into chronic obstructive jaundice models. United semi-hepatectomy, which imitates extended radical surgery for treatment of hilar cholangiocarcinoma, was then performed. The eight minipigs were randomly divided into groups A and B （n=4 minipigs each）. PPVA was performed in Group A but not in Group B. The effects of flow-controlled PPVA on live regeneration after hepatectomy were observed for 30 days after hepatectomy. Results The portal vein PO2 at the immediate time point and on postoperative day 30 was higher in Group A （（47.33±2.43） and （48.50±4.44） mmHg） than in Group B （（35.38±4.06） and （35.55±2.55） mmHg respectively, all P 〈0.01）. The mitotic index of liver cells on postoperative days 14 and 21 was higher in Group A （12.55%±2.85% and 15.25%±1.99% respectively） than in Group B （6.85%±2.10% and 11.88%±1.15% respectively, all P 〈0.05）. The regeneration rate of residual liver on postoperative days 14 and 21 was higher in Group A （24.56%±6.15% and 70.63%±9.83% respectively） than in Group B （11.96%±5.43% and 44.92%±7.42% respectively, P 〈0.05 and P 〈0.01 respectively）.Conclusion Flow-controlled PPVA can promote liver regeneration after hepatectomy and prevent liver failure in minipigs with chronic obstructive jaundice.
文摘In the current study, we sought to establish a novel rat model of portal vein artefialization （PVA） and evaluate its impact on liver regeneration after extended partial hepatectomy （PH）. A total of 105 Sprague-Dawley rats were randomly assigned to three groups： 68% hepatectomy （the PH group）, portal arterialization after 68% hepatectomy （the PVA group）, and fight nephrectomy only （the control group）. Liver regeneration rate （LRR）, 5-bromo-2-deoxyuridine （BrdU） labeling index, and liver functions were assessed on postoperative day 2, 7, 14 and 28. The 28-day survival rates were compared among the three groups. The 28-day survival rates were similar in all groups （P = 0.331）, and the anastomotic patency was 100%. The LRR in the PVA group was significantly higher than that of the PH group within postoperative 14 days （P 〈 0.05）. The PVA and PH group had increased serum alanine aminotransferase levels （232 ±61 U/L and 212 ±53 U/L, respectively） compared with the control group （101 ±13 U/L） on postoperative day 2, whereas from postoperative day 7 to day 28 there were no differences among the three groups. Serum albumin values were higher after the PVA procedure within postoperative day 14, which gradually became comparable on postoperative day 28 among the three groups. The peaks of BrdU labeling index appeared on postoperative day 2 in all rats, and the PVA procedure was associated with increased BrdU labeling index from postoperative day 7 to 28. The 28-day survival of the PVA rats was comparable. Our findings demonstrate that the PVA procedure utilizing portal vein trunk-renal artery microvascular reconstruction promotes remnant liver regeneration and confers beneficial effects on maintaining and even optimizing liver function after extended partial hepatectomy in rats.
