Successful modulation of portal inflow by somatostatin in a porcine model of small-for-size syndrome.
BACKGROUND
Somatostatin may prevent the small-for-size syndrome in subjects undergoing extended hepatectomy by decreasing portal pressure.


METHODS
Twenty pigs underwent 70% hepatectomy (H70 group, n = 7), 90% hepatectomy (H90 group, n = 7), or sham laparotomy (control group, n = 6). Splanchnic hemodynamics was measured before and after an intraoperative infusion of somatostatin.


RESULTS
The portal vein flow normalized to liver weight increased in both H70 and H90 groups (from 125 ± 42 to 342 ± 82 mL/min/100g, P = .031 and from 140 ± 46 to 530 ± 241, P = .016, respectively). The hepatic venous pressure gradient (HVPG) increased in the H90 group only (from 5.5 ± 5.8 to 13 ± 4.9 mm Hg, P = .004). Somatostatin decreased portal vein flow normalized to liver weight in both H70 and H90 groups (from 408 ± 224 to 360 ± 227 mL/min/100g, P = .031 and from 560 ± 190 to 466 ± 189 mL/min/100g, P = .016), and restored a normal HVPG in the H90 group (from 14.3 ± 4.8 to 7.7 ± 6.1 mm Hg, P = .047).


CONCLUSIONS
Somatostatin restores a normal HVPG in the setting of small-for-size syndrome and can be considered as an effective pharmaceutical modality of portal inflow modulation after extended hepatectomy.
Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69317 Cedex 04, Lyon, France; Equipe Mixte de Recherche 3738, Ecole Doctorale EDISS 205, Université Claude Bernard Lyon 1, Villeurbanne, France; Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France.
Kayvan
K
Mohkam
Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69317 Cedex 04, Lyon, France; Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France.
Benjamin
B
Darnis
Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Intensive Care Unit, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
Zoé
Z
Schmitt
Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Intensive Care Unit, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
Serge
S
Duperret
Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69317 Cedex 04, Lyon, France; Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France.
Christian
C
Ducerf
Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69317 Cedex 04, Lyon, France; Equipe Mixte de Recherche 3738, Ecole Doctorale EDISS 205, Université Claude Bernard Lyon 1, Villeurbanne, France; Ecole de Chirurgie de Lyon, Université Claude Bernard Lyon 1, Lyon, France. Electronic address: jean-yves.mabrut@chu-lyon.fr.
Jean-Yves
JY
Mabrut
D000818:Animals; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics; D006498:Hepatectomy; D007262:Infusions, Intravenous; D008099:Liver / Q000033:anatomy & histology / Q000098:blood supply* / Q000601:surgery*; D016031:Liver Transplantation; D009929:Organ Size; D017082:Portal Pressure / Q000502:physiology; D011169:Portal Vein / Q000187:drug effects / Q000502:physiology*; D013004:Somatostatin / Q000008:administration & dosage / Q000494:pharmacology*; D013552:Swine
D002317:Cardiovascular Agents; D013004:Somatostatin
Hepatectomy; Portal inflow; Small-for-size syndrome; Somatostatin; Swine