Regulation of hepatic microcirculation in stepwise liver resection.
BACKGROUND
After liver resection a small-for-size syndrome may result from the reduction of liver volume and additional liver damage caused by hepatic hyperperfusion. Therefore the influence of the extent of liver resection on liver perfusion is investigated.


METHODS
A stepwise liver resection (removal of 30%, 70%, 90%, 95% and 97% of the liver) was performed under inhalation anaesthesia with isoflurane in 6 male Lewis rats. Besides systemic arterial and venous blood pressure the portal pressure and flow was measured and the sinusoidal perfusion was visualized. Sinusoidal diameter, intersinusoidal diameter and functional capillary density were determined.


CONCLUSIONS
A decrease in the portal flow but an increase in the portal pressure was observed. Sinusoidal diameter showed a steady but low increase when up to 70% of the liver was removed but a high increase after 90% or more of the liver was resected. This indicates a decompensation of a regulatory mechanism of sinusoidal perfusion.
Dahmen
U
U
Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. uta.dahmen@uni-due.de
Hall
C A
CA
Madrahimov
N
N
Milekhin
V
V
Dirsch
O
O
D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D002196:Capillaries / Q000033:anatomy & histology / Q000502:physiology; D002496:Central Venous Pressure / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000502:physiology; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008099:Liver / Q000098:blood supply; D008102:Liver Circulation / Q000502:physiology*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D023421:Models, Animal; D017082:Portal Pressure / Q000502:physiology; D011169:Portal Vein / Q000502:physiology; D051381:Rats; D011917:Rats, Inbred Lew; D012119:Respiration; D014741:Video Recording