Sequential embolization of the branches of the bile duct and portal vein to the targeted hepatic lobe in rats.
BACKGROUND
The high recurrence rate of hepatolithiasis and the high operative risk of right posterior, caudate or multiple lobe hepatectomy are the unsettled problems in hepatobiliary surgery. The present study was to investigate the efficacy of chemical hepatectomy performed via applying sequential embolization of the branches of the bile duct and portal vein to the targeted hepatic lobe.


METHODS
The bile duct and portal vein branches of the median hepatic lobe of rats were treated with: 1) bile duct embolization followed by portal vein ligation (BDE+PVL) and 2) portal vein ligation followed by bile duct embolization (PVL+BDE). The efficacy of chemical hepatectomy in BDE+PVL and PVL+BDE groups was compared with that of sole BDE by histology and Western blotting analysis of collagen I expression.


RESULTS
After six weeks of the chemical hepatectomy, rats in the BDE group showed hepatocyte damages, fibrosis and "self-cut" only in the periphery of the embolized lobe. In contrast, rats in the PVL+BDE and BDE+PVL groups exhibited complete necrosis of hepatocytes and replacement with proliferative ductules and collagen fibers, leading to complete fibrosis and "self-cut" phenomenon in the whole targeted lobe. Collagen I expression in the PVL+BDE group was slightly higher than that in the BDE+PVL group; however, no statistically significant difference was noted.


CONCLUSIONS
The sequential embolization of the bile duct and portal vein branches to the targeted hepatic lobe may be a feasible and effective approach to acheive the ideal effect of chemical hepatectomy in a short period of time.
Department of Hepatobiliary Surgery, and Department of Medicine, West China Hospital of Sichuan University, Chengdu 610041, China. lfy_74@vip.163.com.
Anuj
A
Shrestha
Yong
Y
Zhou
Hui
H
Mao
Fu-Yu
FY
Li
Wen-Jie
WJ
Ma
Nan-Sheng
NS
Cheng
Ri-Hua
RH
Xu
Yong-Qiong
YQ
Zhang
Ting
T
Jiang
Huan
H
Feng
Wen
W
Li
Qiang
Q
Han
D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D001652:Bile Ducts / Q000601:surgery*; D001663:Bilirubin / Q000097:blood; D024042:Collagen Type I / Q000378:metabolism; D004621:Embolization, Therapeutic / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D008026:Ligation; D008099:Liver / Q000378:metabolism / Q000601:surgery*; D023421:Models, Animal; D011169:Portal Vein / Q000601:surgery*; D051381:Rats; D017207:Rats, Sprague-Dawley; D016896:Treatment Outcome
D024042:Collagen Type I; D000410:Alanine Transaminase; D001663:Bilirubin