[Clinical and experimental studies on ligation of the draining vein in the remnant liver during hepatectomy].
In recent 8 years we experienced 6 cases of No. 7 and 8 segmentectomies in 140 hepatectomies. In 4 of them resection of the right hepatic vein (RHV) was unavoidable and two were released from RHV resection by using ultrasonic aspiration method. In the former cases non-cirrhotic patients had transient elevation of transaminases after surgery, while cirrhotic patients demonstrated severe liver dysfunction. The latter cases were uneventful after surgery. In the experimental study, the two groups of rats were made by Group-I (Gr-I) with only 40% hepatectomy and Group-II (Gr-II) in which the hepatic veins draining a remnant lobe were ligated after 40% hepatectomy. The remaining liver lobes with intact veins in Gr-I and Gr-II showed normal hepatic regeneration. However, the parenchyma without draining veins in Gr-II revealed severe congestion and necrosis and transaminases in Gr-II elevated significantly higher than Gr-I soon after operation. Thereafter, DNA synthesis of the hepatocytes with 3H-thymidine had a peak value before collateral vessel formation. Consequently, however, the hepatic volume of the vein-ligated region decreased considerably. Thus, clinical and experimental results suggest that the vein-ligated region can not be expected to share the liver function after hepatic lobectomy and hepatic failure may occur in the cirrhotic patients.
Kitazawa
T
T
Second Department of Surgery, Hamamatsu University School of Medicine, Japan.
Nakamura
S
S
Muro
H
H
D000818:Animals; D005260:Female; D006498:Hepatectomy; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000503:physiopathology / Q000601:surgery; D008106:Liver Cirrhosis, Experimental / Q000503:physiopathology / Q000601:surgery; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D051381:Rats; D011919:Rats, Inbred Strains