title: Preserving hepatic artery flow during portal triad blood inflow occlusion improves remnant liver regeneration in rats after partial hepatectomy.
abstract: BACKGROUND
  In the present study, we compared preservation of the hepatic artery flow during liver blood inflow occlusion with total portal triad blood flow clamping (the Pringle maneuver) to examine their effects on liver regeneration in rats after partial hepatectomy.
  
  
  METHODS
  Male Wistar rats were randomized to a control group (without hepatic inflow occlusion), an occlusion of the portal triad (OPT) group (OPT for 30 min under portal blood bypass), and an occlusion of the portal vein (OPV) group (OPV only for 30 min under portal blood bypass). All the rats underwent partial hepatectomy at the end of hepatic blood control. Liver regeneration was assessed on days 3 and 7 after hepatectomy. Liver damage, extracellular signal-regulated kinase-1/2 activation, and cytokine expression of the remnant liver in the first 24 h after hepatectomy were also assessed.
  
  
  RESULTS
  Significantly greater liver regeneration, at a level similar to that of the control group, as indicated by the percentage of the initial liver weight, proliferating cell nuclear antigen and Ki-67 labeling indexes, and technetium-99m galactosyl human serum albumin liver uptake, was observed in the OPV group on day 3 after hepatectomy (P < 0.05 versus the OPT group). Liver damage, as represented by alanine aminotransferase and aspartate aminotransferase measurement and histopathologic examination, was substantially alleviated in the OPV group compared with the OPT group. In contrast to the control and OPV groups, the OPT group had markedly increased extracellular signal-regulated kinase-1/2 activation, heat shock protein 70, and interleukin-6 expression in response to ischemia and partial hepatectomy.
  
  
  CONCLUSIONS
  Our results have indicated that compared with the Pringle maneuver, clamping the portal vein while preserving the hepatic artery flow during partial hepatectomy is better for remnant liver regeneration at an early posthepatectomy stage.
authors.affiliation: Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China.
authors.forename: Peng Fei
authors.initials: PF
authors.lastname: Wang
authors.forename: Chong Hui
authors.initials: CH
authors.lastname: Li
authors.forename: Yong Wei
authors.initials: YW
authors.lastname: Chen
authors.forename: Ai Qun
authors.initials: AQ
authors.lastname: Zhang
authors.forename: Shou Wang
authors.initials: SW
authors.lastname: Cai
authors.forename: Jia Hong
authors.initials: JH
authors.lastname: Dong
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D015153:Blotting, Western; D016207:Cytokines / Q000378:metabolism; D006498:Hepatectomy / Q000379:methods*; D006499:Hepatic Artery / Q000502:physiology*; D008102:Liver Circulation / Q000502:physiology*; D008115:Liver Regeneration / Q000502:physiology*; D008297:Male; D019950:Mitogen-Activated Protein Kinase 1 / Q000378:metabolism; D048052:Mitogen-Activated Protein Kinase 3 / Q000378:metabolism; D011168:Portal System / Q000601:surgery*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D060888:Real-Time Polymerase Chain Reaction
chemical_list: D015415:Biomarkers; D016207:Cytokines; D019950:Mitogen-Activated Protein Kinase 1; D048052:Mitogen-Activated Protein Kinase 3