Beneficial effects of arterialization of the portal vein on extended hepatectomy.
BACKGROUND
Extended hepatectomy may result in postoperative liver failure. The aim of this study was to evaluate the effects of arterialization of the portal vein on oxygen supply, hepatic energy metabolism and liver regeneration after extended hepatectomy.


METHODS
Portal haemodynamics were evaluated 0 or 10 days after arterialization of the portal vein in three experimental groups: 85 per cent partial hepatectomy, 85 per cent partial hepatectomy 10 days after arterialization of the portal vein and 85 per cent partial hepatectomy 10 days after ligation of the hepatic artery. Survival rates, weight of the regenerating liver, levels of adenine nucleotides and hepatic energy charge were assessed.


RESULTS
Arterialization of the portal vein caused a significant increase in partial pressure of oxygen and oxygen saturation. Portal blood flow 10 days after arterialization was significantly increased. Survival rate and weight of the regenerating liver in the group with arterialization of the portal vein were significantly higher than those in the other two groups. The group with arterialization of the portal vein showed the highest levels of adenosine 5'-triphosphate.


CONCLUSIONS
The increase in portal blood flow and oxygen supply produced by arterialization of the portal vein has beneficial effects on hepatic energy metabolism and liver regeneration, and leads to improved survival after experimental extended hepatectomy.
Shimizu
Y
Y
First Department of Surgery, School of Medicine, Chiba University, Japan.
Miyazaki
M
M
Shimizu
H
H
Ito
H
H
Nakagawa
K
K
Ambiru
S
S
Yoshidome
H
H
Nakajima
N
N
D000818:Animals; D001807:Blood Vessel Prosthesis; D004734:Energy Metabolism; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008099:Liver / Q000098:blood supply; D017093:Liver Failure / Q000378:metabolism / Q000517:prevention & control; D008115:Liver Regeneration; D008297:Male; D010100:Oxygen / Q000032:analysis; D010313:Partial Pressure; D017082:Portal Pressure / Q000502:physiology; D011169:Portal Vein / Q000601:surgery*; D051381:Rats; D017208:Rats, Wistar; D016019:Survival Analysis
D010100:Oxygen