title: Marginal hepatectomy in the rat: from anatomy to surgery.
abstract: OBJECTIVE
  Based on the 3-dimensional visualization of vascular supply and drainage, a vessel-oriented resection technique was optimized. The new surgical technique was used to determine the maximal reduction in liver mass enabling a 50% 1-week survival rate.
  
  
  BACKGROUND
  Determination of the minimal liver mass is necessary in clinical as well as in experimental liver surgery. In rats, survival seems to depend on the surgical technique applied. Extended hepatectomy with removal of 90% of the liver mass was long regarded as a lethal model. Introduction of a vessel-oriented approach enabled long-term survival in this model.
  
  
  METHODS
  The lobar and vascular anatomy of rat livers was visualized by plastination of the whole organ, respectively, by corrosion casts of the portal vein, hepatic artery and liver veins. The three-dimensional models were used to extract the underlying anatomic structure. In 90% partial hepatectomy, the liver parenchyma was clamped close to the base of the respective liver lobes (left lateral, median and right, liver lobe). Piercing sutures were placed through the liver parenchyma, so that the stem of portal vein and the accompanying hepatic artery but also the hepatic vein were included.
  
  
  RESULTS
  A 1-week survival rate of 100% was achieved after 90% hepatectomy. Extending the procedure to 95% resection by additional removal of the upper caudate lobe led to a 1-week survival rate of 66%; 97% partial hepatectomy, accomplished by additional resection of the lower caudate lobe only leaving the paracaval parts of the liver behind, resulted in 100% lethality within 4 days.
  
  
  CONCLUSIONS
  Using a anatomically based, vessel-oriented, parenchyma-preserving surgical technique in 95% liver resections led to long-term survival. This represents the maximal reduction of liver mass compatible with survival.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Nodir
authors.initials: N
authors.lastname: Madrahimov
authors.forename: Olaf
authors.initials: O
authors.lastname: Dirsch
authors.forename: Christoph
authors.initials: C
authors.lastname: Broelsch
authors.forename: Uta
authors.initials: U
authors.lastname: Dahmen
mesh_terms: D000818:Animals; D006498:Hepatectomy; D006499:Hepatic Artery / Q000033:anatomy & histology; D006503:Hepatic Veins / Q000033:anatomy & histology; D008099:Liver / Q000033:anatomy & histology*; D008115:Liver Regeneration; D016031:Liver Transplantation; D023421:Models, Animal; D011169:Portal Vein / Q000033:anatomy & histology; D051381:Rats / Q000033:anatomy & histology*; D011917:Rats, Inbred Lew; D020858:Tissue and Organ Harvesting