Establishment of a rat model: Associating liver partition with portal vein ligation for staged hepatectomy

Surgery
Weiwei WeiUta Dahmen

Abstract

We adapted the anatomically oriented parenchyma-preserving resection technique for associating liver partition with portal vein ligation (PVL) for staged hepatectomy (ALPPS) in rats and examined the role of revascularization in intrahepatic size regulation. We performed the procedures based on anatomic study. The ALPPS procedure consisted of a 70% PVL (occluding the left median, left lateral, and right lobes), parenchymal transection (median lobe) and partial (10%) hepatectomy (PHx; caudate lobe). The transection effect was evaluated by measuring the extent of hepatic atrophy or regeneration of individual liver lobes in the ALPPS and control groups (70% PVL and 10% PHx without transection). The survival rates after stage II resection and collateral formation within the portal vein system was examined. Anatomic study revealed a close spatial relationship between the demarcation line and the middle median hepatic vein. This enabled placing the transection plane without injuring the hepatic vein. Transection was achieved via stepwise clamping, followed by 2-3 parenchyma-preserving piercing sutures on both sides of the clamp. Ligated liver lobes atrophy was significantly enhanced after ALPPS compared with the control group. In cont...Continue Reading

References

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Citations

Mar 9, 2017·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·Andras BudaiAttila Szijarto
Sep 28, 2016·World Journal of Gastroenterology : WJG·Demetrios MorisDimitrios Dimitroulis
Aug 3, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Rebecca DealErik Schadde
Nov 25, 2018·Digestive Diseases and Sciences·Jinwei ZhaoLu Yu
Jan 23, 2019·Laboratory Investigation; a Journal of Technical Methods and Pathology·Alexandra DiliIsabelle A Leclercq

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