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PubMed2006

Expression of NCAM in activated portal fibroblasts during regeneration of the rat liver after partial hepatectomy.

In the portal tract of the regenerating liver after partial hepatectomy, vascular and bile ductular remodeling takes place in response to the portal hyperdynamic state and parenchymal hyperplasia. In order to reveal phenotypical changes in the portal fibroblasts, we immunohistochemically investigated neural cell adhesion molecules (NCAM) and alpha smooth muscle actin (alphaSMA) expression and the ultrastructural changes in them during liver regeneration. In the control rat liver, portal fibroblasts were negative for both NCAM and alphaSMA. They became positive for both markers two days after partial hepatectomy, increased in staining intensity, reached a maximum at three to four days, then decreased, being still clearly positive at 14 days. Under an electron microscope, portal fibroblasts from the regenerating liver had larger amounts of cytoplasm and rough endoplasmic reticulum than those from the control liver; thus they might be activated. Additionally, periportal hepatic stellate cells in the regenerating liver were activated with alphaSMA, but without NCAM. The present study has demonstrated that portal fibroblasts express NCAM and alphaSMA in the regenerating liver after partial hepatectomy via transformation into myofibroblasts following reconstruction of the portal tracts.

Animals↗

PubMed2006

Radiofrequency ablation of recurrent hepatocellular carcinoma after hepatectomy: therapeutic efficacy on early- and late-phase recurrence.

OBJECTIVE: Our objective was to assess the efficacy and safety of radiofrequency ablation of recurrent hepatocellular carcinoma (HCC) after hepatectomy and to compare the effects on early- and late-phase recurrence. SUBJECTS AND METHODS: We studied 41 patients with 76 recurrent HCC tumors (diameter range, 2.0-6.6 cm; mean, 3.8 +/- 1.3 [SD] cm) after hepatectomy who underwent sonography-guided percutaneous radiofrequency ablation in our hospital (recurrent-HCC group). The interval between surgery and recurrence ranged from 1 to 96 months (mean, 24.5 months). These patients were divided into an early-recurrence group (20 patients with 41 recurrent HCC tumors) and a late-recurrence group (21 patients with 35 recurrent HCC tumors). Early recurrence was defined as that occurring within 1 year after surgery, and late recurrence was defined as that occurring after 1 year. Another 116 patients with 172 primary HCC tumors (diameter range, 1.2-7.0 cm; mean, 3.9 +/- 1.1 cm) treated by radiofrequency ablation were regarded as a control group. No other therapies were given before radiofrequency ablation in any group. Regular follow-up with enhanced CT was performed to evaluate the treatment results. Ablation was considered successful if no contrast enhancement was detected in the treated area on 1-month CT scans. Indexes including ablation success rate, local recurrence rate, distant recurrence rate, and survival were obtained for analysis and comparison. RESULTS: The ablation success rate, local recurrence rate, distant recurrence rate, and mean overall survival time of the recurrent-HCC group were 93.4% (71/76 tumors), 9.2% (7/76 tumors), 36.6% (15/41 patients), and 30.9 +/- 3.7 months, respectively. The incidence of distant recurrence in the early-recurrence group was significantly higher than that in the late-recurrence group (55.0% vs 19.0%, p = 0.017). The early-recurrence group had a shorter overall survival than did the late-recurrence group (mean overall survival, 16.4 +/- 2.4 vs 42.9 +/- 4.4 months, p < 0.001) or the control group (16.4 +/- 2.4 vs 45.9 +/- 2.5 months, p < 0.001). The survival time of the late-recurrence group was similar to that of the control group (42.9 +/- 4.4 vs 45.9 +/- 2.5 months, p > 0.05). Serious hemorrhage after radiofrequency ablation occurred in one patient in the late-recurrence group and was controlled with conservative treatment. CONCLUSION: Radiofrequency ablation is generally effective and safe in treating recurrent HCC after hepatectomy and is more effective in late recurrence than in early recurrence.

Adult↗

PubMed1976

The effect of hepatectomy on the energy state and on acid-base variables of the rat brain.

The influence of hepatectomy on cerebral energy metabolism was studied in rats in which an end-to-side portacaval anastomosis had been performed one week earlier. The hepatectomy gave rise to an exaggeration of the increase in tissue ammonia content resulting from the shunt. Three hours after the hepatectomy there was a fall in tissue glutamate content but no change in alpha-ketoglutarate. The energy state of the tissue, as evaluated from the concentrations of ATP, ADP, and AMP, was unchanged. There was a significant increase in cerebrospinal fluid pH but no change in intracellular pH.

Acid-Base Equilibrium↗

PubMed1986

Changes in the hepatic capacity of urea-N synthesis, galactose elimination and antipyrine clearance following 70% hepatectomy in the rat.

The capacity of urea-N synthesis (CUNS), galactose elimination capacity (GEC), and antipyrine clearance (APC) was investigated in rats 0, 3, 6, 24, 96, and 240 h after 70% hepatectomy. Sham-operated animals were used as controls. The CUNS was assessed during alanine infusion as urea accumulation in total body water, corrected for intestinal hydrolysis, GEC was measured during constant galactose infusion, and APC by the one-sample method. Immediately after the 70% hepatectomy, CUNS was reduced from 8.9 +/- 2.4 to 3.9 +/- 1.1 mumol (min X 100 g body wt)-1 (mean +/- SD, p less than 0.05), that is, 0.43 times the control value. The corresponding reduction in liver weight was 0.36. After 6 h CUNS rose to 0.62 times the control values versus 0.36 for the liver weight. The recovery of GEC and APC was slower than the recovery of the liver weight, and was only restored to 0.81 and 0.59 times the control value (p less than 0.05), respectively, after 240 h. This study demonstrates that after partial hepatectomy the capacity of urea-N synthesis rate is increased, that is, a compensatory hyperfunction of the remnant liver, and that this function is restored to normal more rapidly than other measures of functional liver mass.

Animals↗

PubMed1987

beta-Hexosaminidase in plasma and liver after partial hepatectomy in normal and cirrhotic rats.

The liver and plasma level of the lysosomal enzyme beta-hexosaminidase was analyzed in partially (about 70%) hepatectomized rats with normal liver or carbon tetrachloride (CCl4)-induced cirrhosis. The enzyme level of the liver did not show marked changes after partial hepatectomy in either normal or cirrhotic rats. In contrast, the plasma basal level was significantly higher in cirrhotic rats and increased to a peak at 6 h, followed by a decrease to a minimum level 24 h after operation. The enzyme returned to its high plasma basal level at 36 h after partial hepatectomy, when the liver had recovered to 70% of its initial weight. In rats with normal liver the plasma beta-hexosaminidase showed another pattern, with a rapid increase at 6 h and thereafter gradually reaching a peak at 36 h after hepatectomy. We conclude that the cells responsible for increased plasma beta-hexosaminidase in cirrhotic rats are situated in the liver.

Alanine Transaminase↗

PubMed1990

Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors.

Liver regeneration and restoration of liver function were studied in six patients who underwent partial hepatectomy with removal of 30-70% of the liver. Liver volume and liver regeneration were studied by single-photon computed tomography (SPECT), using 99mTc-colloid as tracer. The method was assessed in 11 patients by comparing the pre- and post-operative volume measurements with the volume of the resected liver mass. The correlation coefficient between these methods was 0.899 (P less than 0.01). Liver function was determined by measuring the galactose elimination capacity and the caffeine clearance. After a postoperative follow-up period of 50 days the liver had regenerated maximally to a volume of 75 +/- 2% of the preoperative liver mass. Maximal restoration of liver function was achieved 120 days after operation and amounted to 75 +/- 10% for the caffeine clearance and to 100 +/- 25% for the galactose elimination capacity. This study shows that SPECT is a useful method for assessing liver regeneration in patients after partial hepatectomy. Our study furthermore shows that caffeine clearance correlates well with total liver volume, whereas the galactose elimination capacity overestimates total liver volume after partial hepatectomy.

Adult↗

PubMed1984

Hypotensive response to prostacyclin and 6-keto-PGE1 following hepatectomy in the rat.

Prostacyclin (PGI2) is metabolized to 6-keto-prostaglandin E1 (6-keto-PGE1) which is more stable yet equipotent to PGI2 in lowering systemic arterial blood pressure in the dog. In this study, partial hepatectomy was performed to determine the role of the liver in the vasodepressor response to both intravenously administered PGI2 and 6-keto-PGE1. The magnitude and the duration of systemic hypotensive responses were measured in hepatectomized and sham-operated male Wistar rats following less than maximal, equidepressor doses of PGI2 (0.3 microgram/kg), 6-keto-PGE1 (1.0 microgram/kg), and also PGE1 (3.0 micrograms/kg) and PGE2 (3.0 micrograms/kg). Hepatectomy did not significantly alter the magnitude of the systemic hypotensive response to any of the prostaglandins tested. This indicates that the liver and hepatic circulation do not contribute significantly to the hypotensive effect of these prostaglandins by alterations of systemic vascular resistance, venous pooling of blood, or the generation of additional vasoactive metabolites as may be expected following administration of these prostaglandins. However, hepatectomy did significantly increase the duration of the hypotensive response to PGI2 and 6-keto-PGE1 but not PGE1 or PGE2. We conclude that in vivo, the liver has a more significant role in PGI2 and 6-keto-PGE1 inactivation than in the inactivation of PGE1 and PGE2 when administered intravenously. These results also support the relatively greater significance of the lung in the inactivation of PGE1 and PGE2 in vivo.

Alprostadil↗

PubMed2004

Safe major abdominal operations: hepatectomy, gastrectomy and pancreatoduodenectomy in elder patients.

AIM: To evaluate the impact of advanced age on outcome after hepatectomy, gastrectomy and pancreatoduodenectomy. METHODS: Two hundreds and eleven patients undergone hepatectomy, gastrectomy and pancreatoduodenectomy from January 1998 to September 2002 were analyzed retrospectively. Clinicopathologic features and operative outcome of 83 patients aged 65 years or more were compared with that in 128 younger patients aged less than 65 years. RESULTS: The nutritional state, such as pre-operation level of serum albumin and hemoglobin in the older patients was poorer than that in the younger patients. The older patients had higher comorbidities than the younger patients (48.2% vs 15.6%). No significant difference was observed in perioperative mortality, and complication rate between the older and younger patients (2.4% vs 1.6% and 22.9% vs 20.3%, respectively). Multivariate analysis demonstrated that pancreatoduodenectomy, hepatectomy with resection of more than 2 segments and comorbidities were independent predictors of postoperative complication, whereas age was not (P=0.3172). CONCLUSION: It is safe for patients aged 65 years or more to undergo hepatic, pancreatic and gastric resection if great care is taken during perioperative period.

Abdomen↗

PubMed2004

Effects of recombinant human growth hormone on remnant liver after hepatectomy in hepatocellular carcinoma with cirrhosis.

AIM: To explore the effects of recombinant human growth hormone (rhGH) on the remnant liver after hepatectomy in hepatocellular carcinoma with liver cirrhosis. METHODS: Twenty-four patients with hepatocellular carcinoma who underwent hepatectomy were randomly divided into 2 groups: parenteral nutrition (PN) group (n=12) and rhGH+PN group (n=12). Liver function, blood glucose, AFP, serum prealbumin and transferrin were detected before operation, at post-operative d 1 and d 6. Albumin (ALB) mRNA in liver biopsy specimens was detected by RT-PCR at post-operative d 6. Liver Ki67 immunohistochemical staining was studied. RESULTS: On post-operative d 6, compared with PN group, the levels of blood glucose, serum prealbumin, transferrin, the expression of hepatic ALB mRNA and liver Ki67 labeling index were higher in rhGH+PN group. CONCLUSION: rhGH can improve protein synthesis and liver regeneration after hepatectomy in hepatocellular carcinoma with liver cirrhosis.

Adult↗

PubMed2006

Effect of liver regeneration after partial hepatectomy and ischemia-reperfusion on expression of growth factor receptors.

AIM: To investigate the effects of experimental partial hepatectomy and normothermic ischemia-reperfusion damage on the time course of the expression of four different growth factor receptors in liver regeneration. This is relevant due to the potential therapeutic use of growth factors in stimulating liver regeneration. METHODS: For partial hepatectomy (PH) 80% of the liver mass was resected in Sprague Dawley rats. Ischemia and reperfusion (I/R) were induced by occlusion of the portal vein and the hepatic artery for 15 min. The epidermal growth factor receptor, hepatic growth factor receptor, fibroblast growth factor receptor and tumour necrosis factor receptor-1 were analysed by immunohistochemistry up to 72 h after injury. Quantitative RT-PCR was performed at the time point of minimal receptor expression (24 h). RESULTS: In immunohistochemistry, EGFR, HGFR, FGFR and TNFR1 showed biphasic kinetics after partial hepatectomy with a peak up to 12 h, a nadir after 24 h and another weak increase up to 72 h. During liver regeneration, after ischemia and reperfusion, the receptor expression was lower; the nadir at 24 h after reperfusion was the same. To evaluate whether this nadir was caused by a lack of mRNA transcription, or due to a posttranslational regulation, RT-PCR was performed at 24 h and compared to resting liver. In every probe there was specific mRNA for the receptors. EGFR, FGFR and TNFR1 mRNA expression was equal or lower than in resting liver, HGFR expression after I/R was stronger than in the control. CONCLUSION: At least partially due to a post-transcriptional process, there is a nadir in the expression of the analysed receptors 24 h after liver injury. Therefore, a therapeutic use of growth factors to stimulate liver regeneration 24 h after the damage might be not successful.

Animals↗

PubMed2006

Hepatectomy for huge hepatocellular carcinoma in 634 cases.

AIM: To clarify the safety and feasibility of hepatectomy for huge hepatocellular carcinoma (HCC). METHODS: A total of 4765 patients with HCC operated at Tongji Hospital were retrospectively studied, of them, 780 patients had huge HCC (10 cm or more in diameter). Hepatectomy was carried out on 634 patients (81.2%). The majority of the liver resection were major resections, and combined resection of the adjacent organs or structures was common (17.2%). The liver resection was combined with portal vein thrombectomy in 139 patients (21.9%). RESULTS: Postoperative complications were common (26.8%) and required another laparotomy to prevent the complications in 5 patients (0.8%). The 30-d mortality was 2.2%. The main causes of postoperative deaths were liver failure (n = 9), postoperative bleeding (n = 4) and septic complication (n = 1). The 3-, 5- and 10-year survival rates after liver resection were 35.1%, 18.2% and 3.5%, respectively. CONCLUSION: Hepatectomy for huge HCC is safe and effective. It should be used to treat patients with low surgical risks and resectable tumours.

Adult↗

PubMed2006

Differentiation of rat bone marrow stem cells in liver after partial hepatectomy.

AIM: To investigate the differentiation of rat bone marrow stem cells in liver after partial hepatectomy. METHODS: Bone marrow cells were collected from the tibia of rat with partial hepatectomy, the medial and left hepatic lobes were excised. The bone marrow stem cells (Thy(+)CD3(-)CD45RA(-) cells) were enriched from the bone marrow cells by depleting red cells and fluorescence-activated cell sorting. The sorted bone marrow stem cells were labeled by PKH26-GL in vitro and autotransplanted by portal vein injection. After 2 wk, the transplanted bone marrow stem cells in liver were examined by the immunohistochemistry of albumin (hepatocyte-specific marker). RESULTS: The bone marrow stem cells (Thy(+)CD3(-)CD45RA(-) cells) accounted for 2.8% of bone marrow cells without red cells. The labeling rate of 10 microM PKH26-GL on sorted bone marrow stem cells was about 95%. There were sporadic PKH26-GL-labeled cells among hepatocytes in liver tissue section, and some of the cells expressed albumin. CONCLUSION: Rat bone marrow stem cells can differentiate into hepatocytes in regenerative environment and may participate in liver regeneration after partial hepatectomy.

Animals↗

PubMed2004

Effects of partial hepatectomy on the distal ileum in rats.

INTRODUCTION: hepatectomy, both partial resection and transplant, has greatly developed and advanced during the last years as a result of a better understanding of surgical anatomy and the progress of technological means; it has also allowed a widening of surgical indications, including living-donor liver transplantation. The aims of our study was to assess the morphological impact of partial hepatectomy on the distal ileum, since the liver and intestine behave as a unit from an anatomical, functional, and metabolic point of view. MATERIAL AND METHODS: twenty-four Wistar rats were used; they were divided into two groups, a control and an experimental group (30, 90, and 180 days). We studied changes occurred in the distal ileum after a 70% liver resection, taking 4 parameters into account. RESULTS: an important drop in total thickness occurred at the ileum wall in the experimental group (p < 0.001). There were no important differences in villus height with regard to the control group. Thickness at the villi fell significantly (p < 0.01), as did the depth of the crypts, which diminished significantly in relation to the control group (p < 0.001). CONCLUSIONS: a 70% hepatectomy induces trophic changes on the distal ileum that remain in both the short and longer term, and causes atrophy of the ileum wall and a drop in villus thickness.

Animals↗

PubMed1999

A case of hepatocellular carcinoma with bone metastasis responding to radiotherapy after successful hepatectomy of primary lesion.

Radical hepatectomy was carried out on a patient with hepatocellular carcinoma (HCC) located in segment VIII of the liver. The patient was a 56-year-old man who showed positive for hepatitis C antibody and negative for hepatitis B surface antigen. Six months after hepatectomy, a lumbar plane X-ray and computed tomography examination revealed bone metastases in the lumbar vertebrae. The patient was subsequently treated by radiation to the lumbar vertebrae in response to lumbago. The metastatic lesion has been well controlled by radiotherapy on an outpatient basis with no recurrence for 5 years and 3 months. The prognosis of patients with HCC with distant metastases is poor. It is believed that the long survival of this patient can be attributed to successful radiotherapy of the bone metastasis after hepatectomy and the lack of recurrence in the liver.

Aged↗

PubMed1999

A patient with a large hepatocellular carcinoma alive 13 years after repeated transcatheter arterial chemoembolization and hepatectomy.

We describe a rare case of a large hepatocellular carcinoma (HCC) in a patient who survived 13 years after repeated transcatheter arterial chemoembolization (TAE) and hepatectomy. The patient was a 41-year-old woman found in March 1985 to have a large HCC, measuring 14 x 12 cm in diameter and associated with obstruction of the main portal trunk. She underwent TAE 8 times over a period of 1 year. The serum alpha-fetoprotein level decreased from 18342 to 1871 ng/ml. The patient subsequently underwent left hepatectomy on October 9, 1986. Thirteen years after hepatectomy, the patient is being followed up on an outpatient basis and has had no evidence of recurrence.

Adult↗

PubMed1999

Effects of partial hepatectomy on the plasma membrane status and the invertor mechanism of the hepatocyte Na,K-ATPase activity regulation in rats of various age.

The experiments were performed on adult (6-8 months) and old (22-24 months) Wistar rats. Insulin induced plasma membrane hyperpolarization and hepatocyte Na,K-ATPase activation in adult but not in old sham-operated rats. Partial hepatectomy had no effect on the invertor mechanism of Na,K-ATPase activity regulation in the liver of adult rats, while pronounced changes took place in old animals 4 weeks after partial hepatectomy. Insulin induced hyperpolarization in hepatocyte plasma membrane and activation of Na,K-ATPase both in old and adult hepatectomized rats. Invertors, intracellular regulators of the plasma membrane status, played an important role in the mechanism of this insulin-induced hyperpolarization. Four weeks after partial hepatectomy in old animals, the invertor mechanism of hepatocyte plasma membrane regulation appeared again, as well as membrane Na,K-ATPase capability to react to insulin action.

Aging↗

PubMedDate not supplied

Administration of prostaglandin E1 reduces post-operative hepatocellular damage and restores hepatic integrity in patients undergoing hepatectomy.

BACKGROUND/AIMS: The direct protective effects of prostaglandin E1 against hepatic dysfunction are unclear in recent studies. The aim of the present study was to investigate whether post-operative administration of prostaglandin E1 reduces serum concentrations of alpha-glutathione S-transferase, a new indicator of hepatocellular injury, in patients undergoing hepatectomy. METHODOLOGY: The subjects were 15 patients with hepatocellular carcinoma or hilar cholangiocarcinoma undergoing hepatectomy. Prostaglandin E1 was administered to 10 patients (PGE1 group) and was not administered to 5 patients (control group). Prostaglandin E1 was administered for 24 hours from noon on post-operative day 1 to noon on post-operative day 2. Serum concentrations of alpha-glutathione S-transferase, reduced glutathione, cyclic adenosine monophosphate, and total bilirubin, and the concentration of reduced glutathione in bile were measured post-operatively. RESULTS: The serum concentration of alpha-glutathione S-transferase was significantly lower and the serum bilirubin concentration was lower in the PGE1 group than in the control group. The serum concentrations of reduced glutathione and cyclic adenosine monophosphate were significantly higher in the PGE1 group than in the control group. Reduced glutathione in bile was higher in the PGE1 group than in the control group. CONCLUSIONS: The present results show that administration of prostaglandin E1 reduces hepatocellular injury and restores hepatic integrity, post-operatively, in patients undergoing hepatectomy.

Adult↗

PubMedDate not supplied

The effect of octreotide on morphological hepatic regeneration and hepatic functional recovery after a two-thirds hepatectomy in rats.

BACKGROUND/AIMS: The aim of this study was to clarify the effect of octreotide on either morphological hepatic regeneration or hepatic function after a two-thirds hepatectomy in rats. METHODOLOGY: The rats were separated into two groups as follows: group 1 received 100 microg of octreotide acetate subcutaneously every 6 hours from 24 hours before hepatic resection until sacrifice; group 2 received 0.9% saline solution instead of octreotide as a control. Morphological hepatic regeneration, protein synthesis and mitochondrial function were all studied. RESULTS: The regenerative rate in liver volume and the BrdU labeling index in group 1 were significantly lower than those in group 2. The levels of glutamic acid dehydrogenase were significantly lower in group 1 than those in group 2 at 24 (64.2+/-14.6 and 77.8+/-8.3 IU/l, respectively), 36 (46.1+/-14.4 and 60.6+/-5.9 IU/l, respectively) and 48 hours (39.7+/-13.7 and 51.0+/-11.8 IU/l, respectively) after hepatectomy. At 24 hours after hepatectomy, the levels of arterial ketone body ratio was higher in group 1 than in group 2 (0.67+/-0.05 and 0.51+/-0.07, respectively), and the energy charge of the liver was also higher in group 1 than in group 2 (0.662+/-0.031 and 0.605+/-0.053, respectively). CONCLUSIONS: Our results suggest that morphological hepatic regeneration is not necessarily synchronized with hepatic functional recovery. In addition, hepatic functional recovery was preserved by keeping the energy metabolism in hepatocytes, even when the use of octreotide suppressed morphological hepatic regeneration.

Animals↗