Hyperbaric oxygenation after portal vein emobilization for regeneration of the predicted remnant liver.
BACKGROUND
Liver failure often develops after extensive liver resection. Preoperative portal vein embolization to induce compensatory hypertrophy in the predicted remnant liver decreases clinical complications after hepatectomy. The aim of this study was to examine whether hyperbaric oxygenation (HBO) after portal vein embolization increases compensatory hypertrophy of the predicted liver remnant. We performed portal vein ligation and HBO in rats to investigate whether HBO after portal vein embolization increases compensatory hypertrophy of the predicted remnant liver.


METHODS
Rats were divided into four groups that underwent (1) laparotomy only (control group); (2) right portal vein ligation (RPL group); (3) RPL followed by HBO at 2 atm (HBO-2 atm group; 1 h/day, 5 days/week for 2 weeks); or (4) RPL followed by HBO at 3 atm (HBO-3 atm group). Laparotomy was repeated after 2 weeks in each group; serum levels of albumin and hepatocyte growth factor (HGF) were measured, and the ratio of the weights of nonligated to ligated hepatic segments and the percentage of hepatocytes expressing proliferating cell nuclear antigen (PCNA) in ligated hepatic segments were determined.


RESULTS
In rats that had received HBO after RPL, serum levels of HGF, weight ratios of nonligated to ligated hepatic segments, and the percentage of PCNA-positive hepatocytes in nonligated liver were significantly higher than those in the control group. Furthermore, rats that had undergone 3-atm HBO after RPL had significantly higher serum levels of HGF and percentages of PCNA-positive hepatocytes in nonligated hepatic segments.


CONCLUSIONS
Preoperative HBO after portal vein embolization may be useful for inducing compensatory hypertrophy of the predicted remnant liver.
Uwagawa
T
T
Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan. forza@lime.plala.or.jp
Unemura
Y
Y
Yamazaki
Y
Y
D000818:Animals; D004621:Embolization, Therapeutic; D017228:Hepatocyte Growth Factor / Q000097:blood; D022781:Hepatocytes / Q000737:chemistry; D006931:Hyperbaric Oxygenation; D008026:Ligation; D008099:Liver / Q000098:blood supply / Q000502:physiology* / Q000601:surgery; D017093:Liver Failure / Q000517:prevention & control; D008115:Liver Regeneration; D008297:Male; D009929:Organ Size; D011169:Portal Vein; D011183:Postoperative Complications / Q000517:prevention & control; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D051381:Rats; D017207:Rats, Sprague-Dawley; D012709:Serum Albumin
D018809:Proliferating Cell Nuclear Antigen; D012709:Serum Albumin; D017228:Hepatocyte Growth Factor