TY - JOUR
T1 - Portal vein embolization induces more liver regeneration than portal vein ligation in a standardized rabbit model
AU - van den Esschert, Jacomina W.
AU - van Lienden, Krijn P.
AU - de Graaf, Wilmar
AU - Maas, Martinus A. W.
AU - Roelofs, Joris J. T. H.
AU - Heger, Michal
AU - van Gulik, Thomas M.
PY - 2011
Y1 - 2011
N2 - Background. Portal vein ligation (PVL) and portal vein embolization (PVE) are used to induce hypertrophy of the future remnant liver before major liver resection. The aim of our study was to compare the hypertrophy response of the liver after PVL versus PVE in a rabbit model. Methods. Twenty rabbits were divided into an embolization group (n = 10) and a ligation group (n = 10). Both groups were divided in 2 subgroups of 5 rabbits that were humanely killed after days 7 and 14. The portal vein branches to the 3 cranial liver lobes (80% of the liver) were occluded. Regeneration of the caudal liver lobe was measured using volumetry based on computed tomography on days 3, 7, 10, and 14. Immunohistochemistry for Ki-67 and RAM11 was performed to quantify proliferating cells and macrophages. In addition, tissue tumor necrosis factor-alpha and interleukin-6 were assessed. Results. The caudal liver volume increased over time in both groups (P <.001), but this increase was greater after PVE than after PVL (P = .001) with a mean degree of hypertrophy of 15% +/- 4% and 20% +/- 2%, respectively. When comparing the groups on the separate time points, a difference was found on days 10 and 14 (P = .008 and P = .016, respectively). These data were confirmed by Ki-67 staining, which showed a greater number of proliferating hepatocytes on day 7 after embolization (P = .016). Cytokine analysis of liver tissue did not show significant differences between the ligation and embolization groups on days 7 and 14. Conclusion. PVE is superior to PVL in terms of the extent of the hypertrophy response in this rabbit model. (Surgery 2011;149:378-85.)
AB - Background. Portal vein ligation (PVL) and portal vein embolization (PVE) are used to induce hypertrophy of the future remnant liver before major liver resection. The aim of our study was to compare the hypertrophy response of the liver after PVL versus PVE in a rabbit model. Methods. Twenty rabbits were divided into an embolization group (n = 10) and a ligation group (n = 10). Both groups were divided in 2 subgroups of 5 rabbits that were humanely killed after days 7 and 14. The portal vein branches to the 3 cranial liver lobes (80% of the liver) were occluded. Regeneration of the caudal liver lobe was measured using volumetry based on computed tomography on days 3, 7, 10, and 14. Immunohistochemistry for Ki-67 and RAM11 was performed to quantify proliferating cells and macrophages. In addition, tissue tumor necrosis factor-alpha and interleukin-6 were assessed. Results. The caudal liver volume increased over time in both groups (P <.001), but this increase was greater after PVE than after PVL (P = .001) with a mean degree of hypertrophy of 15% +/- 4% and 20% +/- 2%, respectively. When comparing the groups on the separate time points, a difference was found on days 10 and 14 (P = .008 and P = .016, respectively). These data were confirmed by Ki-67 staining, which showed a greater number of proliferating hepatocytes on day 7 after embolization (P = .016). Cytokine analysis of liver tissue did not show significant differences between the ligation and embolization groups on days 7 and 14. Conclusion. PVE is superior to PVL in terms of the extent of the hypertrophy response in this rabbit model. (Surgery 2011;149:378-85.)
U2 - https://doi.org/10.1016/j.surg.2010.07.045
DO - https://doi.org/10.1016/j.surg.2010.07.045
M3 - Article
C2 - 20817235
SN - 0039-6060
VL - 149
SP - 378
EP - 385
JO - Surgery
JF - Surgery
IS - 3
ER -