Effects of Partial Portal Arterialization on Liver Regeneration after Extended Hepatectomy

Satoru Ohtawa, Masaru Miyazaki, Akira Ogata, Shinichi Hayashi, Nobuyuki Nakajima

First Department of Surgery, Chiba University School of Medicine

Thirty-six mongrel dogs underwent 70% partial hepatectomy (HTX), and splenic arterial-portal venous shunt (AP-shunt) was performed for partial portal arterialization. The experimental groups were as follows: group I, 70% HTX; group II, 70% HTX + splenectomy; group III, 70% HTX + splenectomy + AP-shunt. The effect of splenic AP-shunt on hepatic function and hepatic regeneration af.ter 70% HTX was determined. Arterial ketone body ratio was higher in group III than in group I and group II on the first postoperative day (POD) (p<0.05) . Hepaplastin levels were also higher in group III than in group I and group II on POD 7 (p<0.05). Hepatic DNA synthesis was markedly increased in group III on POD 4, 7 compared to group I and group II (p<0.05) and significantly increased expresion of MIB-1 staining as an indicator of mitosis was found in group III. It is concluded that partial portal arterialization by splenic AP-shunt might enhance hepatic regeneration and hepatic functional revovery after 70% HTX through increased oxygen supply to the remaining liver.

Key words
extended hepatectomy, portal venous arterialization, arterial ketone body ratio, liver regeneration, hepatic DNA synthesis

Reprint requests
Masaru Miyazaki First Department of Surgery, Chiba University School of Medicine
1-8-1, Inohana, Chuoku, Chiba, 260 JAPAN

Accepted
May 8, 1996

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