Additional partial hepatectomy at the time of portal vein ligation accelerates the regeneration of the future liver remnant

GND
1218239484
ORCID
0000-0001-8904-7099
Affiliation
Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany
Hua, Chuanfeng;
GND
130659894X
Affiliation
Department of Visceral-, Transplant-, Thoracic- and Vascular Surgery, University Clinic Leipzig, Leipzig, Germany
Wei, Weiwei;
GND
1317521706
Affiliation
Department of Radiotherapy and Radiation Oncology, Jena University Hospital, Jena, Germany
Zhang, Tianjiao;
GND
1218236000
ORCID
0000-0002-6523-804X
Affiliation
Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany
Xu, Fengming;
Affiliation
Institute of Pathology, Klinikum Chemnitz gGmbH, Chemnitz, Germany
Dirsch, Olaf;
Affiliation
Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
Homeyer, André;
GND
172370469
Affiliation
Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany
Settmacher, Utz;
GND
114498405X
ORCID
0000-0003-3483-3388
Affiliation
Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany
Dahmen, Uta

Portal vein ligation (PVL) has been adopted to induce hypertrophy of the future liver remnant (FLR) in patients with primarily irresectable liver tumor. However, regeneration of the FLR is not always sufficient to allow curative resection of the portally-deprived tumor-bearing liver lobe. We hypothesize that simultaneous hepatectomy (PHx) and PVL augments regeneration of the FLR and that the effect is related to the extent of the additional resection. Seventy-two Lewis rats were enrolled into 3 groups: 20%PVL + 70%PHx; 70%PVL + 20%PHx; 90%PVL. Animals were observed for 1, 2, 3 and 7 days postoperatively (n = 6/time point). Liver enzymes, caudate liver/body-weight-ratio, BrdU-proliferation-index (PI), proliferating-cell-nuclear-antigen (PCNA)-mRNA-expression level and autophagy-related-proteins were evaluated. Compared with 90% PVL, additional PHx induced significantly more hypertrophy during the observation time, which was confirmed by significantly higher PI and higher level of PCNA-mRNA expression. Similarly, the additional PHx induced more autophagy in the FLR compared with PVL alone. However, both effects were not clearly related to the extent of additional resection. Additional resection augmented liver regeneration and autophagy substantially compared with PVL alone. Therefore, we concluded that autophagy might play a critical role in regulating hepatocyte proliferation and the size of the FLR after simultaneous PVL + PHx.

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