The Effect Of Resection Congested Liver Tissue To The Recover Of Hepatic Function After Rat Liver Tissue Subtotal Resection On Early Stage

Background and objective: Liver hepatic congestion is a common complication after hepatectomy. A wide range of hepatic congestion will lead to liver function injury and increase the probability of liver failure. The impact is still unclear that removing the congestive liver tissue will lead to on the liver function of the patients after hepatectomy. In this study, Sprague–Dawley rats were divided into three groups,group one: 70% of liver resection group(middle + the left lobe); group two: liver resection group(middle + the left lobe) combined with the caudate lobe hepatic congestion(hepatic congestion volume accounting for one third of the remaining liver volume); group three: liver resection group(middle + the left lobe) combined with the caudate lobe hepatic congestion after three minutes. Examine the effect of relevant indicators of liver function and mortality. Explore the effect of resection congested liver tissue to the recover of hepatic function after rat liver tissue subtotal resection on early stage.Methods: This study is divided into two phases, the first phase: in the phase of modeling practice, we referred to the paper of animal model on rat partial hepatectomy, and got acquainted with the anatomical features of rats hepatic lobes, practicing making stable-related animal models.The second phase: 90 Sprague–Dawley rats were divided into three groups randomly. Non-hepatic congestion group: mid + left lobectomy. Hepatic congestion group: mid + left lobectomy + caudate lobe congestion. Hepatic congestion remove group: mid + left lobectomy + caudate lobe congestion and resect the caudate lobe after three minutes. We use venous pressure measurement ruler measuring portal pressure. Extract blood from IVC and analyze TB after 12 and 24 hours. Collected the liver specimens. Observed the pathological changes of liver tissue by HE staining. Immunohistochemistry was used to detect the infiltration of macrophages in liver tissue. Detected the expression of cleaved casepase-3 protein by western blot. Detecting the expression of inflammatory cytokines(TNF-a, IL-6) by RT-PCR.analyze the survival rate. Test index compared with single factor analysis of variance and LSD-t test, the survival analysis was based on Kaplan-Meier curve and Log-rank test.Results: Part one: rat model of 70% liver resection 、model of 70% hepatectomy combined caudate lobe hepatic congestion and model of 70% hepatectomy with hepatic congestion caudate lobe resection were stable and conducive to the study of liver resection model. Part two: 1. The five day survival rate after surgery in each group: hepatic congestion group was significantly lower than non-hepatic congestion group, and the survival rate of hepatic congestion group after resection of liver hepatic congestion was significantly higher than hepatic congestion group without resection operation. 2. The total bilirubin levels after surgery: the total bilirubin level of hepatic congestion group was higher than that of non-hepatic congestion at 24 hours after operation.and the total bilirubin level of hepatic congestion group after resection of liver hepatic congestion at 24 hours after operation was significantly lower than hepatic congestion group without resection operation. 3.The pathological changes(HE staining) of each group were: 24 hours after operation, significant swelling of liver cells and disappear of liver sinusoidal were happened in hepatic congestion group. Compared with hepatic congestion resection group and non-hepatic congestion group, more cell vacuolar degeneration were appeared in liver tissues of hepatic congestion group. 4, The cleaved caspase-3 protein expression in each group after surgery were: the expression of cleaved casepase-3 protein in hepatic congestion group at 24 hours after operation was higher than that of hepatic congestion resection group and non-hepatic congestion group. 5、The relative expression of TNF-a, IL-6 in each group : the expression of TNF-a and IL-6 in hepatic congestion group at 12 hours and 24 hours after operation was higher than that of hepatic congestion resection group and non-hepatic congestion group. 6, The infiltration of macrophages and neutrophils after operation in each group : 24 hours after operation, Compared with hepatic congestion resection group and non-hepatic congestion group, hepatic congestion group appears more macrophages and neutrophils infiltration. 7, The portal vein pressure change of each group after operation: The portal vein pressure of hepatic congestion group were significantly higher than that of hepatic congestion resection group and non-hepatic congestion group.Conclusions: 1. We made 3 models of hepatic hepatic congestion :Rat model of 70% liver resection 、 model of 70% hepatectomy combined caudate lobe hepatic congestion and model of 70% hepatectomy with hepatic congestion caudate lobe resection.the overall success rates in all of the models above were very high and all the models were stable. The model can be used for researching on the early influence of hepatic function after rat liver tissue subtotal resection. 2. In the case of rat with 70% hepatectomy, early caudate lobe hepatic congestion can cause cells vacuolar degeneration, increased apoptosis、inflammation and portal pressure, that leading to hepatic function go to worse in the part of the non-hepatic congestion liver tissue and ultimately increase mortality. The resection of hepatic congestion caudate lobe can reduce these changes, reducing the mortality of rats.