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Liver volume and function in rat models of regenerative liver surgery

再生肝手术大鼠模型的肝脏体积和功能

基本信息

批准号：
423392184
负责人：
Dr. Jan Heil
金额：
--
依托单位：
Institut für Anästhesiologie
依托单位国家：
德国
项目类别：
Research Fellowships
财政年份：
2019
资助国家：
德国
起止时间：
2018-12-31 至 2020-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/423392184?language=en
关键词：
Liver volume function rat models

项目摘要

Resections of liver metastasis of the colon and rectum are the most common reason for liver resections in the western world. The advances of chemotherapies and surgical techniques have increased the pool of patients with resectable livers. Especially techniques to increase the future liver remnant prior to surgery to prevent post-hepatectomy liver failure increase the limits of resectability.Nevertheless, methods like portal vein embolization, portal vein ligation and two-staged hepatectomies are limited by a moderate hypertrophy of the future liver remnant. To overcome this limitation, “Associating Liver Partition and Portal vein ligation for Staged hepatectomy” (ALPPS) was proposed to expand resectability. The combination of portal vein ligation and parenchymal transection leads to a more extensive hypertrophy in a shorter period of time. However, the analysis of the outcomes after ALPPS demonstrated an unexpected increase in post-hepatectomy liver failure. This observation suggested that liver volume potentially overestimates liver function after induction of a rapid hypertrophy. The aim of this project is to find out, if rapid hypertrophy after ALPPS or an extended liver resection in a rat model, is associated with a lack of an increase of liver function relative to liver volume. Furthermore, it will be investigated, if a slow hypertrophy after portal vein ligation also causes an incongruence of the increase of volume and function or not. Liver volume and function are measured by MRI using Gd-EOB-DTPA (Primovist®).The importance of this project is underlined by the fact, that key facts about functionality of hypertrophied parenchyma is still missing, while regenerative surgery is widely used in clinic. The aim of this project is to provide clinicians with basic knowledge about the functionality of liver regeneration after induction of a rapid hypertrophy by using a rodent model.

在西方世界，结肠和直肠的肝转移切除是最常见的肝切除原因。随着化学疗法和外科技术的进步，可切除肝脏的患者数量增加。特别是在手术前增加未来肝脏残留以防止肝切除术后肝功能衰竭的技术增加了可切除性的限制。然而，门静脉栓塞、门静脉结扎和两阶段肝切除术等方法受到未来肝脏残留中度肥大的限制。为了克服这一局限性，“联合肝脏分割和门静脉结扎分期肝切除术”（ALPPS）被提出来扩大可切除性。门静脉结扎和肝实质横断的组合导致更广泛的肥大在较短的时间内。然而，ALPPS后的结局分析表明，肝切除术后肝功能衰竭意外增加。这一观察结果表明，诱导快速肥大后，肝脏体积可能高估了肝功能。该项目的目的是找出在大鼠模型中ALPPS或扩大的肝切除术后快速肥大是否与肝功能相对于肝脏体积缺乏增加有关。此外，还将研究门静脉结扎后的缓慢肥厚是否也会导致体积和功能增加的不协调。使用Gd-EOB-DTPA（Primovist®）通过MRI测量肝脏体积和功能。该项目的重要性在于以下事实，即关于肥大实质功能的关键事实仍然缺失，而再生手术在临床上广泛使用。本项目的目的是为临床医生提供基本知识的功能性肝再生诱导后，通过使用啮齿动物模型快速肥大。