title: Intermittent hepatic pedicle clamping reduces liver and lung injury.
abstract: BACKGROUND
  Temporary occlusion of the hepatic hilum is used to control hemorrhage during liver resection, but can result in widespread organ dysfunction.
  
  
  METHODS
  Adult male Sprague-Dawley rats were subjected to either continuous (Group C) or intermittent (Group R) hepatic ischemia. The total ischemia time (60 min) was divided into four 15-min periods in Group R. Blood and lung tissue specimens were collected 2 h after the induction of ischemia (early phase), and 24 h after the termination of ischemia (late phase). Plasma lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), tumor necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6) concentrations were measured. Histologic sections were studied using hematoxylin and eosin, as well as naphthol AS-D chloroacetate esterase techniques.
  
  
  RESULTS
  In the early phase, LDH, ALT, TNF-alpha, and IL-6 concentrations were significantly higher in Group C than in Group R. Pulmonary septal thickening and polymorphonuclear leukocyte infiltration were less severe in Group R than in Group C. These differences were significant in the late phase.
  
  
  CONCLUSIONS
  Intermittent hepatic pedicle clamping reduces the ischemia-reperfusion injury not only to the liver but also to the lungs. This technique may improve the outcome in patients undergoing liver resection.
authors.affiliation: Second Department of Surgery, Fukui Medical University, Fukui, Matsuoka, 910-11, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kimura
authors.forename: R
authors.initials: R
authors.lastname: Muraoka
authors.forename: T
authors.initials: T
authors.lastname: Horiuchi
authors.forename: T
authors.initials: T
authors.lastname: Tabo
authors.forename: M
authors.initials: M
authors.lastname: Uchinami
authors.forename: J
authors.initials: J
authors.lastname: Yokomachi
authors.forename: K
authors.initials: K
authors.lastname: Doi
mesh_terms: D000410:Alanine Transaminase / Q000378:metabolism; D000818:Animals; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001784:Blood Gas Analysis; D001794:Blood Pressure; D015850:Interleukin-6 / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008026:Ligation; D008099:Liver / Q000098:blood supply* / Q000201:enzymology / Q000601:surgery; D008107:Liver Diseases / Q000378:metabolism / Q000601:surgery*; D008297:Male; D009504:Neutrophils / Q000166:cytology; D011650:Pulmonary Alveoli / Q000098:blood supply* / Q000473:pathology; D011654:Pulmonary Edema / Q000378:metabolism* / Q000473:pathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000378:metabolism*; D013525:Surgical Instruments; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase