The Effects of Temporary Interruption of Hepatic Blood Circulation

Large-scale liver surgeries often require the temporary interruption of hepatic blood circulation, a process that can lead to potentially irreversible damage to the liver and other internal organs. This study aims to investigate the macro-morphological, histological, and ultrastructural changes in the liver and other organs following temporary hepatic blood flow interruption.  Experiments were conducted on 26 rats, randomly assigned to two groups: Group I (control: five rats) and Group II (rats that underwent bile duct ligation: 21 rats). On day 6, the hepatoduodenal ligament was ligated. Decapitation was performed at specific time points following ligature removal: 15 minutes (n = 7), 24 hours (n = 7), and 48 hours (n = 7). Tissue samples were collected for general morphological, histochemical, and electron microscopic analysis. The investigation revealed that damage to the liver and other organs after temporary hepatic blood flow interruption and subsequent restoration was more prolonged and severe in the presence of cholestasis than in its absence. Fifteen minutes after the ligature removal, new bile duct formation or "neoductulogenesis" was observed, creating an additional reservoir for congested bile. At 24 and 48 hours, a marked decrease in neoductule numbers was noted. This was attributed to the flow of congested bile into the bloodstream through new pathways, drainage of intrahepatic bile ducts, and reduced intrahepatic bile pressure. These changes precipitated hepatocyte metaplasia into ductal biliary epithelial cells and promoted further neoductulogenesis.