The prognosis after surgical resection of pancreatic carcinoma mostly depends on tumor factors. In this study, it was difficult to identify the determinants of long-term survival in patients with resectable tumors.

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We have reported that infusion of recombinant human hepatocyte growth factor (rhHGF) stimulates liver regeneration after hepatectomy in cirrhotic rats and increases the level of serum lipids and secretion of very-low density lipoprotein (VLDL). Studies were now performed to determine whether rhHGF directly influences lipid synthesis and its secretion in cultured rat hepatocytes. Isolated cells were cultured in the presence or absence of rhHGF (20 ng/mL) for 2 days. During the first 12 hours, rhHGF transiently inhibited the release of lipids (triacylglycerol, total cholesterol, and phospholipids), but stimulated their releases with maximal levels achieved at 36 hours. Hepatocyte growth factor (HGF), also known as a scatter factor, was isolated and purified from the plasma of patients with fulminant hepatic failure 1 as well as from rat platelets. 2 Native and recombinant human HGF (rhHGF) was found to be a potent mitogen for rat and human hepatocytes in primary culture. 3 HGF likely plays a crucial role in liver regeneration, as its production is induced in patients with fulminant hepatic failure 4 and in rats with hepatotoxininduced hepatic damage. [5][6][7] The hypothesis is also supported by recent clinical reports in which HGF levels were markedly increased and were associated with liver regeneration following resection in patients with hepatocellular carcinoma and metastatic liver tumors. [8][9][10][11] Mature human HGF is produced from a single chain precursor by cleavage at arginine 494 with a serine protease and consists of a heavy chain and a light chain held together by a disulfide bond. 1,12,13 The heterodimeric form is required for its biologic activities. 14,15 HGF is a heparin-binding glycoprotein and acts predominantly as a mitogen on a wide variety of epithelial cells and as a motogen and morphogen by stimulating the tyrosine kinase activity of its specific receptor encoded by the MET proto-oncogene. 7,16,17 The HGF receptor is a 190-kd heterodimer which is composed of a 50-kd ␣-chain covalently linked to a 145-kd ␤-chain, which contains the intracellular tyrosine kinase domain. The HGF receptor, when autophosphorylated in response to HGF, binds a number of substrata containing the Src homology region 2 domain such as phosphatidylinositol-3-kinase and phospholipase C-␥.We have recently found that a continuous infusion of rhHGF stimulates liver regeneration in cirrhotic rats after 45% hepatectomy. 18 In addition, rhHGF increased serum lipid levels (triacylglycerol, total cholesterol, phospholipids, and free fatty acids) twofold to fourfold over control rats on days 2 and 3 after hepatectomy. Roos et al. 19 observed that rhHGF markedly elevated serum triacylglycerol and cholesterol levels even in normal mice without hepatectomy. These reports suggest that HGF may be involved in hepatic lipid synthesis and lipoprotein secretion. There are several reports demonstrating the involvement of HGF in DNA synthesis and cell mitosis during liver regeneration and recovery following hepatotoxin exposure. [20][...

LUS, when combined with laparoscopic manipulations, may overcome many of the limitations of laparoscopy alone in the investigation of pancreatic lesions by providing an accurate diagnosis and assessment of the size and extent of the local dissemination.

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