Hashimoto M, Watanabe G
Department of Digestive Surgery, Toranomon Hospital, Tokyo, Japan.
Surgery. 1999 Sep;126(3):541-7.
Posthepatectomy liver insufficiency is one of the most serious problems associated with a major hepatic resection, especially in the cirrhotic liver, which has less functional reserve than the normal liver. Evaluation of morphologic liver regeneration is important in cirrhotic rats, as well as in the normal liver, and assessment of functional capacity in cirrhosis is clinically important for preventing hepatic insufficiency of the remnant liver after hepatectomy.
We evaluated the functional capacity of the cirrhotic liver induced by carbon tetrachloride in rats and studied the correlation between morphologic and functional restoration of the liver after partial hepatectomy in comparison with healthy rats. Morphologic restoration of the liver after hepatectomy was evaluated on the basis of remnant liver weight, proliferating cell nuclear antigen labeling index, and the DNA content of the regenerating liver. Functional restoration was evaluated by the indocyanine green disappearance rate and serum aminopyrine clearance.
Morphologic restoration in cirrhotic rats was delayed in comparison with healthy rats. Although functional capacity in the cirrhotic rats was diminished, functional restoration was advanced after a two-thirds hepatectomy, in comparison with morphologic restoration.
Functional restoration in cirrhotic rats after partial hepatectomy is advanced in comparison with morphologic restoration.
肝切除术后肝功能不全是与大型肝切除相关的最严重问题之一,尤其是在肝硬化肝脏中,其功能储备比正常肝脏少。评估肝硬化大鼠以及正常肝脏的形态学肝再生很重要,并且评估肝硬化中的功能能力对于预防肝切除术后残余肝脏的肝功能不全在临床上具有重要意义。
我们评估了四氯化碳诱导的大鼠肝硬化肝脏的功能能力,并与健康大鼠比较,研究了部分肝切除术后肝脏形态学和功能恢复之间的相关性。肝切除术后肝脏的形态学恢复通过残余肝脏重量、增殖细胞核抗原标记指数和再生肝脏的DNA含量进行评估。功能恢复通过吲哚菁绿消失率和血清氨基比林清除率进行评估。
与健康大鼠相比,肝硬化大鼠的形态学恢复延迟。虽然肝硬化大鼠的功能能力降低,但与形态学恢复相比,三分之二肝切除术后功能恢复提前。
与形态学恢复相比,肝硬化大鼠部分肝切除术后的功能恢复提前。