Somatostatin perfusion and modulation of portal inflow after major liver resection: Response to “Post hepatectomy liver failure (PHLF)-Recent advances in prevention and clinical management”

Rhaiem, Rami; Zimmermann, P.; Brustia, Raffaele; Lhuaire, Martin; Piardi, Tullio; Kianmanesh, Réza; Sommacale, Danièle

doi:10.1016/j.ejso.2021.03.256

Cited by 3 publications

(1 citation statement)

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“…In a recent update on this series, portal inflow modulation using SST was administered in 31 patients undergoing major or extended major hepatectomy for oncological indications. Among them, five (16%) met PHLF criteria, though neither grades nor outcomes were reported [48].…”

Section: Discussionmentioning

confidence: 99%

Somatostatin Therapy Improves Stellate Cell Activation and Early Fibrogenesis in a Preclinical Model of Extended Major Hepatectomy

Hessheimer

Vengohechea

Maza

et al. 2021

Cancers

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Liver resection treats primary and secondary liver tumors, though clinical applicability is limited by the remnant liver mass and quality. Herein, major hepatic resections were performed in pigs to define changes associated with sufficient and insufficient remnants and improve liver-specific outcomes with somatostatin therapy. Three experimental groups were performed: 75% hepatectomy (75H), 90% hepatectomy (90H), and 90% hepatectomy + somatostatin (90H + SST). Animals were followed for 24 h (N = 6) and 5 d (N = 6). After hepatectomy, portal pressure gradient was higher in 90H versus 75H and 90H + SST (8 (3–13) mmHg vs. 4 (2–6) mmHg and 4 (2–6) mmHg, respectively, p < 0.001). After 24 h, changes were observed in 90H associated with stellate cell activation and collapse of sinusoidal lumen. Collagen chain type 1 alpha 1 mRNA expression was higher, extracellular matrix width less, and percentage of collagen-staining areas greater at 24 h in 90H versus 75H and 90H + SST. After 5 d, remnant liver mass was higher in 75H and 90H + SST versus 90H, and Ki-67 immunostaining was higher in 90H + SST versus 75H and 90H. As well, more TUNEL-staining cells were observed in 90H versus 75H and 90H + SST at 5 d. Perioperative somatostatin modified portal pressure, injury, apoptosis, and stellate cell activation, stemming changes related to hepatic fibrogenesis seen in liver remnants not receiving treatment.

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Section: Discussionmentioning

confidence: 99%