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Bacterial translocation and intestinal capillary permeability following major liver resection in the rat
Abstract:
Bacterial infections constitute a major cause of morbidity and mortality after major liver resection and mechanisms of this type of complication have been poorly understood. The present study evaluated the translocation of enteric bacteria to mesenteric lymph nodes, viscera, and the systemic circulation and gut capillary permeability of a fine ultrastructural tracer in rats subjected to sham hepatectomy or 70% hepatectomy. Furthermore, the preventive effects of water-soluble ethylhydroxyethyl cellulose (EHEC) were studied. Cultures of all samples from rats subjected to sham hepatectomy or 70% hepatectomy with preoperative intravenous administration of EHEC were bacteriologically negative. The incidence of bacterial translocation from the gut to the systemic circulation and mesenteric lymph nodes was 30 and 80%, respectively (P < 0.01), and to the liver and kidneys 50 and 40%, respectively (P < 0.05), 12 hr after 70% hepatectomy. Intestinal capillary permeability and endothelial cell membrane permeability increased with the development of bacterial translocation. Translocating bacteria appeared within the cytoplasm of capillary endothelial cells. EHEC restored the changes in gut capillary permeability induced by major liver resection. These results indicate that gut capillary permeability may play an important role in maintaining the integrity of the gut barrier function and that increased permeability may be associated with the development of gut barrier failure.
Insights
Major liver resection increases bacterial translocation from the gut, impairing gut barrier function. Ethylhydroxyethyl cellulose (EHEC) may prevent this by restoring gut capillary permeability.
Area of Science:
- Gastroenterology
- Hepatology
- Surgical Complications
Background:
- Bacterial infections are a significant cause of morbidity and mortality post-liver resection.
- The mechanisms underlying post-hepatectomy bacterial complications remain poorly understood.
Purpose of the Study:
- To investigate bacterial translocation and gut capillary permeability after major liver resection in rats.
- To evaluate the preventive effects of ethylhydroxyethyl cellulose (EHEC) on these complications.
Main Methods:
- Rats underwent either sham hepatectomy or 70% hepatectomy.
- Bacterial translocation was assessed in mesenteric lymph nodes, viscera, and systemic circulation.
- Gut capillary and endothelial cell membrane permeability were evaluated using an ultrastructural tracer.
- The effect of preoperative EHEC administration was examined.
Main Results:
- 70% hepatectomy led to significant bacterial translocation to lymph nodes (80%), systemic circulation (30%), liver (50%), and kidneys (40%).
- Increased intestinal capillary and endothelial cell membrane permeability correlated with bacterial translocation.
- Translocating bacteria were observed within capillary endothelial cells.
- EHEC administration prevented changes in gut capillary permeability.
Conclusions:
- Gut capillary permeability is crucial for maintaining gut barrier integrity.
- Increased permeability following major liver resection contributes to gut barrier failure.
- EHEC shows potential in mitigating bacterial translocation and preserving gut barrier function after hepatectomy.