Simultaneous extensive resection of the liver and the pancreas in dogs

Abstract

Mortality, morbidity, liver function and regeneration were evaluated in dogs that had undergone simultaneous major resection of the liver and the pancreas. The 10-week survival rate was only 25% in the dogs that underwent 70% hepatectomy with more than 92% pancreatectomy, and many of them died of liver failure. Long-term survival was observed in more than 60% of the dogs after 70% hepatectomy with less than 92% pancreatectomy or after 40% hepatectomy with more than 92% pancreatectomy. The liver regeneration rate was reduced with the extent of the pancreatectomy, and the reduction was remarkable especially when more than 92% of the pancreas was resected. The frequency of diabetes was reduced when the pancreatectomy was combined with hepatectomy. Hyperlipemia and fatty liver were noted in all the dogs of the group that underwent more than 92% pancreatectomy alone. They were observed also in the postoperative diabetic groups but not in non-diabetic groups. The postoperative recovery of hepatic function and liver regeneration were delayed after simultaneous hepatectomy-pancreatectomy. Also, postoperative carbohydrate and lipid metabolism was better maintained in the hepatectomy-pancreatectomy groups than in the pancreatectomy-alone groups.

Mechanisms of Hepatic Regeneration Following Portal Vein Embolization and Partial Hepatectomy: A Review

“…Interestingly, dogs subjected to 70% hepatectomy combined with pancreatectomy had delayed recovery of hepatic function and more limited regenerative capacity than dogs who underwent hepatectomy alone. The reduction in liver regeneration was proportional to the extent of the pancreatectomy, and the reduction was most dramatic when more than 90% of the pancreas was resected 67. These results demonstrate that the pancreas plays an important role in hepatic regeneration, at least partly through the release of insulin.…”

“…The reduction in liver regeneration was proportional to the extent of the pancreatectomy, and the reduction was most dramatic when more than 90% of the pancreas was resected. 67 These results demonstrate that the pancreas plays an important role in hepatic regeneration, at least partly through the release of insulin. Therefore, normoglycemia using insulin should be achieved before performing PVE of PH in diabetic patients.…”

Analysis of 100 Consecutive Hepatectomies: Risk Factors in Patients with Liver Cirrhosis or Obstructive Jaundice

“…A collective review for this extensive surgery in Japan has shown high morbidity and mortality rates: 76% and 38%, respectively [34]. In their experimental model of dogs, Kawarada et al [35] reported that the mortality rate was high after simultaneous extensive resection of the liver and pancreas; they furthermore revealed that hepatic regeneration was markedly impaired with the additional pancreatic resection.…”

Vacuolar Hepatocyte Degeneration Induced by Infusion of 20% Glucose Solution with Insulin after Hepatopancreatectomy in Rats

“…operations performed in each institution. 14 In laboratory studies, Kawarada et al 15 established a variety of liver and pancreas resection models using adult mongrel dogs. Their results showed that the 4-week survival rate was 40% in dogs with 70% hepatectomy and 92% pancreatectomy, with death being ascribed to hepatic failure due to poor liver regeneration.…”