Prior Ligation of Portal Branches Improves Survival after a 90% Portal Hepatectomy in the Rat

Abstract

The ligation of portal branches is known to induce an atrophy of the deprived lobes and a hypertrophy of the nonligated lobes. In this work, we examined if this response occurs when the ligation affects 90% of the liver mass and if it is able to influence the survival rate after a hepatectomy of this magnitude. In male Wistar rats, major portal branches were ligated, keeping open only a small branch supplying the papillary lobes. The ligated lobes underwent a progressive weight loss and their DNA synthesis remained at the level of the controls. The nonligated lobes started to gain weight on the first postoperative day and had increased about 5-fold by the 14th day. The DNA synthesis in these lobes was greatly enhanced with a peak increase at 24 h. Two weeks after a similar ligation of portal branches, the ligated lobes, representing initially 90% of the liver mass, were resected and 80% of the rats survived. In the control group submitted only to a sham operation 2 weeks before, all rats died within 48 h after resection of the corresponding lobes. These results demonstrate that ligation of portal branches feeding 90% of the liver mass can be well tolerated and induces an atrophy of the ligated lobes and a hypertrophy of the nonligated lobes. This procedure, which improves the survival rate after an extended hepatectomy performed 2 weeks later, could find some clinical application.

Two-Stage Portal Vein Ligation Facilitates Liver Regeneration in Rats

“…Although the 90% PVL model used in the present study has only been described by Li et al [28] , they reported that all animals survived without any problem. Also, unlike hepatic artery ligation, severe ischemia does not occur in hepatocytes in the portal-vein-ligated lobe [29] , and survival in rats is 100% even after 90% hepatectomy [30] , suggesting 90% PVL as a safe procedure with minimal hepatocyte damage and no risk of liver failure.…”

Small-for-Size Syndrome in the Rat: Does Size or Technique Matter?

“…Ninety percent hepatectomy in rats was introduced into experimental surgery as a model of fulminant hepatic failure [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] showing a high lethality. Kubota et al [30] pioneered a surgical technique that allowed a 100% survival rate after 90% PH in rats.…”