[Two-stage hepatectomy with preoperative portal vein embolization in rats]

We studied the functional reserve and ability to regenerate of non-embolized liver made hypertrophic by portal vein embolization (PVE) to evaluate the usefulness of two-stage hepatectomy with preoperative PVE. Rats underwent one of four treatments: 1, 70% hepatectomy; 2, 70% hepatectomy 7 days after PVE; 3, 30% hepatectomy; and 4, sham operation. Liver weight, the bromodeoxyuridine labeling index (LI), and the mitotic index (MI) were calculated after surgery. The lipid peroxide level of the liver, serum hepatic enzyme activities, total bilirubin concentration, prothrombin time, and antithrombin-3 activity were also assayed after surgery in each group. Non-embolized lobes made hypertrophic by PVE regenerated further after resection of the embolized portion of the liver. The increases in liver weight, LI, and MI in group 2 were significantly lower than in group 1, but tended to be higher than in group 3. In group 2, lipid peroxidation in the liver and postoperative disorders of liver function and the coagulation system were significantly less than in group 1, and were similar to those in group 3. Preoperative PVE increases not only the weight but also the function of the residual liver, which makes extended hepatectomy safer.