[Effects of preoperative transcatheter portal embolization (TPE) on prevention of hepatic failure after massive hepatectomy].
Effects of TPE on prevention of hepatic failure after massive hepatectomy were studied experimentally using dogs. A 70% or 85% hepatectomy (Hx) was performed two weeks after TPE. All of the 70%Hx groups with(+)/without(-) TPE were alive for over two weeks after hepatectomy. While all of the 85%Hx group without TPE died, eight of ten in the 85%Hx group with TPE survived. Without TPE, total bilirubin levels in sera were elevated markedly in the 85%Hx group and moderately in the 70%Hx group after hepatectomy. The levels of escaped enzymes in sera, such as GOT or GPT, were also elevated remarkably in the TPE(-) groups. Although the levels of these enzymes were also high in the 85%Hx.TPE(+) group, these values were as same as those of 70%Hx.TPE(-) group. In the 85%Hx.TPE(-) group, critical diminution of functional hepatic cell mass and severe portal hypertension occurred after hepatectomy and coagulopathy and death followed to these phenomena. TPE might prevent the onset of these critical phenomena, and diminish the damage caused by massive hepatectomy. These results suggest that TPE is useful for prevention of postoperative hepatic failure so that we could perform massive hepatectomy safely, and extend the operative indication.
Sakai
Y
Y
First Department of Surgery, Yamagata University, School of Medicine, Japan.
Ishiyama
S
S
Tsukamoto
M
M
Makuuchi
M
M
D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D004285:Dogs; D004621:Embolization, Therapeutic / Q000379:methods; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D008107:Liver Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D011169:Portal Vein; D011300:Preoperative Care; D015996:Survival Rate
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin