Shiroiwa H, Usami M, Ohyanagi H, Saitoh Y
First Department of Surgery, Kobe University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1993 Mar;94(3):250-8.
Hepatic regeneration of cirrhotic liver following partial hepatectomy was evaluated in the rats following portal triad cross clamp (Pringle's maneuver). Cirrhotic rats were induced by repeated intraperitoneal injection of thioacetamide. Sixty eight percent of partial hepatectomy was performed under general anesthesia with or without total hepatic normothermic ischemia. Pringle's maneuver consisted of 4 times repetition of the combination of 15-minute ischemia and 15-minute reperfusion. Rats were sacrificed on 1, 7, and 28 postoperative days. The increasing rate of regenerated liver, the labeling index (LI) by histochemical measurement of BrdU positive hepatocyte, biochemical tests of the blood were evaluated in non cirrhotic and cirrhotic rats. Cirrhotic rats tolerated Pringle's maneuver well, without portal congestion as observed in non cirrhotic rats, suggesting the formation of porto-systemic shunt in cirrhotic rats. The inhibition in DNA synthesis and hepatic regeneration rate was observed in liver cirrhosis. However, no statistical significant difference in hepatic regeneration was observed in cirrhotic rats with or without Pringle's maneuver. In conclusion, the rat with cirrhotic liver tolerated Pringle's maneuver well and the maneuver itself was not harmful for hepatic regeneration following the partial resection.
在大鼠门静脉三联交叉钳夹（普林格尔手法）后，评估部分肝切除术后肝硬化肝脏的肝再生情况。通过反复腹腔注射硫代乙酰胺诱导大鼠肝硬化。在全身麻醉下，有或无全肝常温缺血的情况下进行68%的部分肝切除术。普林格尔手法包括15分钟缺血和15分钟再灌注的组合重复4次。在术后第1、7和28天处死大鼠。评估非肝硬化和肝硬化大鼠再生肝的增加率、通过对BrdU阳性肝细胞进行组织化学测量的标记指数（LI）以及血液生化检测。肝硬化大鼠对普林格尔手法耐受性良好，未观察到非肝硬化大鼠中出现的门静脉充血，提示肝硬化大鼠形成了门体分流。在肝硬化中观察到DNA合成和肝再生率受到抑制。然而，在接受或未接受普林格尔手法的肝硬化大鼠中，肝再生未观察到统计学上的显著差异。总之，肝硬化大鼠对普林格尔手法耐受性良好，该手法本身对部分切除术后的肝再生无害。
