Ladurner Ruth, Traub Frank, Schenk Martin, Königsrainer Alfred, Glatzle Jörg
Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seyler-Street 3, D-72076 Tübingen, Germany.
HPB Surg. 2009;2009:306740. doi: 10.1155/2009/306740. Epub 2009 Mar 31.
The liver has an enormous capacity to regenerate itself. The aim of this study was to evaluate whether the regeneration is due to hypertrophy or hyperplasia of the remnant liver after extended resection and whether a portosystemic shunt is beneficial.
An extended left hemihepatectomy was performed in 25 pigs, and in 14 after performing a portosystemic shunt. During follow up, liver regeneration was estimated by macroscopic markers such as liver volume and size of the portal fields [mm(2)] as well as the amount of hepatocytes per portal field and the amount of hepatocytes per mm(2).
Regardless of the operation procedure, the volume of the remnant liver increased about 2.5 fold at the end of the first week after resection. The size of the portal fields increased significantly as well as the number of hepatocytes in the portal fields. Interestingly, the number of hepatocytes per mm(2) remained the same.
After extended resection, liver regeneration was achieved by an extensive and significant hyperplasia of hepatocytes within the preexisting portal fields and not by de novo synthesis of new portal fields. However, there was no difference in liver regeneration regarding the operation procedure performed with or without portosystemic shunt.
肝脏具有强大的自我再生能力。本研究的目的是评估肝扩大切除术后肝脏再生是由于残余肝脏的肥大还是增生，以及门体分流是否有益。
对25头猪进行了扩大左半肝切除术，其中14头在进行门体分流术后进行了该手术。在随访期间，通过肝脏体积、门静脉区域大小[mm(2)]等宏观指标以及每个门静脉区域的肝细胞数量和每平方毫米的肝细胞数量来评估肝脏再生情况。
无论手术方式如何，切除术后第一周结束时残余肝脏体积增加约2.5倍。门静脉区域大小以及门静脉区域内的肝细胞数量均显著增加。有趣的是，每平方毫米的肝细胞数量保持不变。
肝扩大切除术后，肝脏再生是通过既有门静脉区域内肝细胞的广泛且显著增生实现的，而非通过新门静脉区域的从头合成。然而，在进行或未进行门体分流的手术方式下，肝脏再生并无差异。
