Experimental study on hepatic inflow occlusion in rabbits

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Liver regeneration

Background:

• Hepatic resection is a critical treatment for liver tumors.
• Preserving the liver remnant's function is crucial for patient survival.
• Inflow occlusion techniques are used to minimize blood loss during resection.

Purpose of the Study:

• To compare the efficacy of different hepatic inflow occlusion methods.
• To evaluate the impact of these methods on liver remnant viability.
• To determine the optimal technique for preserving liver function during resection.

Main Methods:

• Three inflow occlusion methods were tested in 30 rabbits: portal triad clamping (PTC), selective hepatic artery reserving (SHAR), and selective hemihepatic vascular occlusion (SHHVO).
• Occlusion durations varied, with some groups experiencing 30 minutes and others 20 minutes of ischemia.
• Liver remnant function was assessed by monitoring serum glutamic-pyruvic transaminase (GPT) levels and evaluating hepatocyte damage post-resection.

Main Results:

• Mortality rates were high (66.7%) with 30 minutes of PTC and SHAR.
• 20 minutes of hepatic ischemia using PTC or SHAR caused irreversible hepatocyte damage and elevated GPT levels.
• SHHVO resulted in only a mild, temporary GPT rise and no significant hepatic pathology, indicating preserved liver function.

Conclusions:

• Selective hemihepatic vascular occlusion (SHHVO) is superior to PTC and SHAR for preserving liver remnant function.
• SHHVO minimizes hepatocyte damage and mortality associated with hepatic resection.
• This technique offers a promising approach for safer and more effective liver surgeries.