| [Objective] Portal hyperperfusion is a very common clinical phenomenon, which can be seen both in partial resection of the liver and living donor liver transplantation(LDLT). Owing to decreasing area of hepatic sinus vascular bed after extensive hepatectomy, postoperative acute portal hypertension is given rise to when the entire stream of portal veneous blood is directly through the remnant liver. Splenic artery ligation/splenectomy can reduce the portal blood flow to some extent and alleviate the high portal vein perfusion.Wistar rats are used to build a 70% hepatectomy model, and then we research the effect of splenic artery ligation/ splenectomy on portal veneous pressure,liver function recovery and hepatic regeneration.[Methods] Preliminary experiment is carried out in early experiments and a rat model of 70%hepatectomy (removal of the left lobe and the middle, keep the triangular lobe, the right lobe and caudate lobe) is established. Then 60 male wistar rats(Beijing Academy of Military Medical Sciences) aging 6-8 weeks, weighing 200-220g,were randomly divided into three groups (random number table method): A, B, C group. Each group has 20 rats. A group undergo 70%liver resection and splenic artery ligation, B group undergo 70%hepatectomy and splenectomy. C group 70%liver resection alone.5 rats in each group are randomly sacrificed dayl, day3, day5, day7 after operation. Portal veneous pressure in rats are monitored preoperative and postoperative at each observation time point. Blood from the inferior vena cava is used to do blood test and liver function test, and serum after standing and centrifugalization, is used to detect hepatocyte growth factor (HGF) by enzyme-linked immunosorbent assay (ELISA).Record rat weight,liver wet weight,count liver to body rate. Make single-cell suspension from part of the liver by mechanical method, ditect proportion of S phase with flow cytometry. Part of the liver is stored in the-80℃, and the remaining part of liver is fixed by formaldehyde to do routine HE staining. Results were analyzed using SPSS 13.0 statistical analysis software. [Results] Establish a stable 70%hepatectomy model in rats. A, B, C group of rats obtain long-term survival with no complications such as bleeding and infection. Liver/body weight ratio of each group gradually increased over time, and reach the most significant increasing on the third postoperative day. Liver/body weight ratio of A and B groups are less than C group on the first postoperative day(P<0.05), but they are higher than C group on the third,fifth,seventh day after surgery (P<0.05), there is no significant difference between A and B group. Portal pressure of the C group was significantly higher than before on the day after surgery (P <0.05).Although both A and B groups on the first postoperative day are slightly higher compared with the preoperative value (P<0.05), they are both less than C group. A, C groups on the platelet count did not differ significantly at all time points, but are much smaller than B (P<0.05). Postoperative value of ALT, AST, TBIL, DBIL of three groups decreased over time. Serum ALT, AST, TBIL, DBIL levels of A and B groups were less than C (P<0.05),but there is no significant difference between them. Postoperative HGF concentrations among three groups are not significantly different at all time points (P> 0.05). Postoperative proportion of S phase of three groups increase gradually over time, reach a peak three days after surgery, then gradually decrease, still kept at a high level five days after surgery. At various time points both A and B groups on postoperative S phase fraction were significantly higher than C(P<0.05),which is no significant difference between them.[Conclusion]1. rat 70%hepatectomy and splenic artery ligation/splenectomy benefits to reduce portal vein pressure postoperative. Compared with simple hepatectomy, liver cell is slightly damaged, which is conducive to liver function postoperative recovery.2. Compared with the simple liver resection surgery, rat 70%hepatectomy and splenic artery ligation/splenectomy helps to promote liver regeneration, which have a certain relationship with the change of portal vein pressure.3. rat 70%hepatectomy and splenic artery ligation has the same effect in reducing portal vein pressure, promoting liver regeneration, and have no significant effect on the platelet counts after surgery, compared to 70%hepatectomy and splenectomy, Surgical procedures is easier and more secure. |
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