Mild steatosis impairs functional recovery after liver resection in an experimental model

Background: Mild steatosis has been thought not to affect outcome after liver resection. However, recent studies have reported impaired postoperative recovery of patients with mild steatosis. This study evaluated the recovery of hepatic functional reserve during regeneration in a rat model of mild steatosis and liver resection. Methods: Male Wistar rats had a standard methione- and choline-deficient diet to induce mild steatosis before 70 per cent liver resection. Evaluation of hepatobiliary function was by Tc-99m-labelled mebrofenin scintigraphy. Mebrofenin uptake rate, the time for maximum uptake (T peak) and the time required for peak activity to decrease by 50 per cent (T-1/2 peak) were assessed 1, 2, 3 and 7 days after liver resection, along with regeneration of the remnant liver, hepatocellular and sinusoidal damage, and hepatic adenosine 5 '-triphosphate (ATP) levels. Results: Liver regeneration and proliferative response in mild steatotic rats were no different from those in controls. However, the mebrofenin uptake rate was lower (P <0.050) and the recovery of hepatic ATP impaired (P <0.050) in animals with mild steatosis. Hepatocellular damage was increased (P <0.050) but sinusoidal endothelial cell function was not affected after liver resection in mildly steatotic rats. Conclusion: Mild steatosis impaired functional recovery and increased hepatocellular damage after liver resection