title: Cellular liver regeneration after extended hepatic resection in pigs.
abstract: BACKGROUND
  The liver has an enormous capacity to regenerate itself. The aim of this study was to evaluate whether the regeneration is due to hypertrophy or hyperplasia of the remnant liver after extended resection and whether a portosystemic shunt is beneficial.
  
  
  METHODS
  An extended left hemihepatectomy was performed in 25 pigs, and in 14 after performing a portosystemic shunt. During follow up, liver regeneration was estimated by macroscopic markers such as liver volume and size of the portal fields [mm(2)] as well as the amount of hepatocytes per portal field and the amount of hepatocytes per mm(2).
  
  
  RESULTS
  Regardless of the operation procedure, the volume of the remnant liver increased about 2.5 fold at the end of the first week after resection. The size of the portal fields increased significantly as well as the number of hepatocytes in the portal fields. Interestingly, the number of hepatocytes per mm(2) remained the same.
  
  
  CONCLUSIONS
  After extended resection, liver regeneration was achieved by an extensive and significant hyperplasia of hepatocytes within the preexisting portal fields and not by de novo synthesis of new portal fields. However, there was no difference in liver regeneration regarding the operation procedure performed with or without portosystemic shunt.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seyler-Street 3, D-72076 Tübingen, Germany. ruth.ladurner@med.uni-tuebingen.de
authors.forename: Ruth
authors.initials: R
authors.lastname: Ladurner
authors.forename: Frank
authors.initials: F
authors.lastname: Traub
authors.forename: Martin
authors.initials: M
authors.lastname: Schenk
authors.forename: Alfred
authors.initials: A
authors.lastname: Königsrainer
authors.forename: Jörg
authors.initials: J
authors.lastname: Glatzle