title: Hepatic Hemodynamic Changes Following Stepwise Liver Resection.
abstract: OBJECTIVE
  Extended liver resection has increased during the last decades. However, hepatic hemodynamic changes after resection and the consequent complications like post hepatectomy liver failure are still a challenging issue. The aim of this study was to systematically evaluate the role of stepwise liver resection on hepatic hemodynamic changes.
  
  
  METHODS
  To evaluate this effect we performed 25, 50, and 75 % sequential liver resections in 10 pigs. Before and after each resection, the hepatic artery flow and portal vein flow in relation to the remnant liver volume (RLV) as well as hepatic vascular pressures were measured and compared between the groups.
  
  
  RESULTS
  Following sequential liver resection, the hepatic artery flow /100 g decreases and the portal vein flow increases up to 17 and 167 % following extended liver resection (75 %), respectively. Also, during stepwise liver resection, the portal vein pressure increases gradually up to 33 % following extended hepatectomy (75 %).
  
  
  CONCLUSIONS
  Sequential decrease in the RLV decreases the hepatic artery flow /100 g and increases the portal vein flow /100 g and portal vein pressure. As the consequence, the liver goes under more poor-oxygenated blood supply and higher pressure. This may be one of the most important mechanisms of the post hepatectomy liver failure in case of extended liver resection.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Golriz
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Saroa
authors.initials: S
authors.lastname: El Sakka
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Ali
authors.initials: A
authors.lastname: Majlesara
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Arman
authors.initials: A
authors.lastname: Edalatpour
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Hafezi
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Nahid
authors.initials: N
authors.lastname: Rezaei
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Camelia
authors.initials: C
authors.lastname: Garoussi
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Jalal
authors.initials: J
authors.lastname: Arwin
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Arash
authors.initials: A
authors.lastname: Saffari
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Raisi
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Arezou
authors.initials: A
authors.lastname: Abbasi
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. arianeb_mehrabi@med.uni-heidelberg.de.
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
mesh_terms: D000818:Animals; D006439:Hemodynamics; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods; D006499:Hepatic Artery; D008102:Liver Circulation / Q000502:physiology*; D017093:Liver Failure / Q000209:etiology*; D008297:Male; D017082:Portal Pressure; D012039:Regional Blood Flow; D013552:Swine
keywords: Hepatectomy; Hepatic artery; Portal vein