Microcirculation changes during liver resection--a clinical study.
BACKGROUND
In this study we aimed to evaluate effects of liver resection on hepatic microcirculation. In addition we wanted to study if histological liver damage could be detected intra-operatively.


METHODS
40 patients undergoing hepatic resection were included and grouped according to if they were operated with a major or minor resection. Hepatic microcirculation measurements were made intra-operatively before and after liver resection with sidestream dark-field (SDF) imaging. Red blood cell velocity (RBCV), sinusoidal diameter and functional sinusoidal density were determined.


RESULTS
After hepatic resection RBCV increased in both the minor and major groups (44 μm/s, P=0.016 and 121 μm/s, P=0.002). RBCV in patients with histological damages was 225 (148-464) μm/s vs. 161 (118-329) μm/s in patients with no damage (P=0.016).


CONCLUSIONS
A hepatic resection leads to an increase of sinusoidal RBCV. SDF imaging could potentially be used to intraoperatively identify histological damages.
Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden.
Jan
J
Nilsson
Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden.
Sam
S
Eriksson
Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden.
Per-Jonas
PJ
Blind
Department of Pathology, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden.
Pehr
P
Rissler
Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden. Electronic address: christian.sturesson@med.lu.se.
Christian
C
Sturesson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D004912:Erythrocytes / Q000166:cytology; D005234:Fatty Liver; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007432:Intraoperative Period; D017078:Laser-Doppler Flowmetry; D008099:Liver / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D008102:Liver Circulation; D008297:Male; D008833:Microcirculation; D008875:Middle Aged
D018686:Anesthetics, Intravenous
Chemotherapy; Hepatic microcirculation; Liver function; Sidestream dark-field imaging; Steatosis