Institute of Liver Transplantation, General Hospital of Armed Police Forces, Beijing 100039, PR China.
Med Hypotheses. 2009 Dec;73(6):925-6. doi: 10.1016/j.mehy.2009.06.047. Epub 2009 Jul 28.
The biliary leakage is a common and even lethal postoperative complication to the patients after hepatectomy. However, we found that the patients who underwent this lethal postoperative complication could potentially acquire a faster restoration of remnant liver volume comparing with those without postoperative biliary leakage. We surmise that inflammatory response induced by biliary leakage after partial hepatectomy may be the one of reasons for this phenomenon. Abnormal levels of TNF-alpha, IL-6, and STAT3 caused by biliary leakage may be a main reason for fast liver regeneration. On the other hand, we hypothesize that biliary leakage may promote liver regeneration by activating the immune system after partial hepatectomy. Our hypothesis might provide a novel therapeutic strategy for patients who underwent liver failure after partial hepatectomy. For instance, the exogenous infection or controlling biliary leakage may be reasonable and deserve further study. With the aid of animal model of postoperative biliary leakage or intraabdominal bacterial infections, this hypothesis could be partially or fully confirmed.
胆漏是肝切除术后患者常见甚至致命的术后并发症。然而，我们发现经历这种致命术后并发症的患者与无术后胆漏的患者相比，残肝体积的恢复速度可能更快。我们推测，部分肝切除术后胆漏引起的炎症反应可能是这种现象的原因之一。胆漏引起的 TNF-α、IL-6 和 STAT3 水平异常可能是快速肝再生的主要原因。另一方面，我们假设胆漏可能通过激活部分肝切除术后的免疫系统来促进肝再生。我们的假设可能为部分肝切除术后肝功能衰竭的患者提供一种新的治疗策略。例如，外源性感染或控制胆漏可能是合理的，值得进一步研究。借助术后胆漏或腹腔内细菌感染的动物模型，这一假设可以得到部分或完全证实。
