Portal vein ligation is as effective as sequential portal vein and hepatic artery ligation in inducing contralateral liver hypertrophy in a rat model.
OBJECTIVE
Dual embolization of the hepatic artery and portal vein (PV) has been proposed to enhance contralateral liver regeneration before resection. The aim of this study was to evaluate the effect of PV ligation compared with simultaneous or sequential dual ligation on regeneration, proinflammatory response, and liver damage.


METHODS
Single hepatic artery ligation (HAL), PV ligation (70%), or dual ligation of the hepatic artery and PV (70%) simultaneously or sequentially within a 48-hour interval was performed in a rat model. Liver regeneration, proinflammatory mediators, hepatocellular synthetic function and injury, histopathology, and apoptosis were assessed at a maximum of 14 days after surgery.


RESULTS
Sequential dual ligation resulted in a faster increase in hepatocyte proliferation at 24 hours without additional increase in liver mass compared with PV ligation after 14 days. Both dual ligations significantly increased proinflammatory response in plasma and in the regenerating liver compared with PV ligation alone. Fourteen days after PV ligation, the hepatic parenchyma was completely restored, whereas fibronecrosis was seen in the sequentially dual-ligated groups and complete necrosis was seen in simultaneously ligated groups. Increased apoptosis in the regenerating liver and prolonged hepatic dysfunction were observed after both dual ligations.


CONCLUSIONS
PV ligation is as effective as dual ligation in inducing liver regeneration. No additional benefit of arterial ligation was observed.
Veteläinen
Reeta
R
Department of Surgery, Surgical Laboratory, Academic Medical Center, Meibergdreef 9, IWO-1, 1105 AZ Amsterdam, The Netherlands.
Dinant
Sander
S
van Vliet
Arlène
A
van Gulik
Thomas M
TM
D000818:Animals; D017209:Apoptosis; D016207:Cytokines / Q000378:metabolism; D006499:Hepatic Artery / Q000601:surgery*; D006984:Hypertrophy; D008026:Ligation; D008099:Liver / Q000098:blood supply* / Q000378:metabolism; D008111:Liver Function Tests; D008115:Liver Regeneration; D008297:Male; D009504:Neutrophils / Q000502:physiology; D009195:Peroxidase / Q000378:metabolism; D011169:Portal Vein / Q000601:surgery*; D051381:Rats; D017208:Rats, Wistar
D016207:Cytokines; D009195:Peroxidase