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Experimental study about extension of surgical indications of liver resection by percutaneous transhepatic portal vein embolization

经皮肝穿刺门静脉栓塞术扩大肝切除手术适应证的实验研究

基本信息

批准号：
05671081
负责人：
KINOSHITA Hiroaki
金额：
$ 1.41万
依托单位：
Osaka City University Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1993
资助国家：
日本
起止时间：
1993 至 1995
项目状态：
已结题

项目摘要

The usefulness pf preoperative portal vein embolization (PVE) in rats for extension of surgical indications for hepatocellular carcinoma were evaluated. The portal branch that supplies 70% of the total volume of the liver was embolized. The liver weight, mitotic index, and DNA synthesis increased after PVE.ODC activity and hepatic levels of putrescine and spermidine also increased after PVE.PVE caused cell proliferation and hypertrophy in the nonembolized part of the liver in the normal rats and even in those with cirrhosis ; the extent of the cell proliferation and hypertrophy in cirrhotic rats was smaller than that in normal rats. Lipid peroxidation in the liver and postoperative disorders of liver function were significantly less in the rats those underwent liver resection with preoperative PVE than in the rats without PVE.Hepatic disfunction and the endotoxin-induced liver injury were significantly slighter in the rats those underwent liver resection with preoperative PVE than in the rats without PVE.After portal branch ligation (PVL) caused massive necrosis of hepatocytes in the central and intermediate zone of the liver lobule, and apoptotic hepatocytes, which contributes in part to the volume reduction of ligated liver lobes, were observed. Apoptosis of hepatocytes plays a role in reconstructing the architecture of hepatic cell cords. Number of Kuppfer cells and lymphcytes decreased in the ligated lobes. The number of Kupffer cells and its function were preserved in the nonligated lobe. Preoperative portal vein embolization is useful for increasing the safety of liver resection and for extension of indications of major hepatectomy for hepatocellular carcinoma.

探讨大鼠术前门静脉栓塞术（PVE）对扩大肝癌手术指征的作用。占肝脏总容积70%的门静脉分支被栓塞。PVE后肝脏重量、有丝分裂指数和DNA合成增加。PVE后ODC活性和肝脏腐胺和亚精胺水平也升高。PVE可引起正常大鼠及肝硬化大鼠肝脏非栓塞部位细胞增殖和肥厚；肝硬化大鼠的细胞增殖和肥大程度明显小于正常大鼠。术前行PVE肝切除术的大鼠肝脏脂质过氧化和术后肝功能紊乱明显少于未行PVE的大鼠。术前行PVE肝切除术的大鼠肝功能障碍和内毒素性肝损伤明显轻于未行PVE的大鼠。门静脉分支结扎术（PVL）引起肝小叶中央和中间区肝细胞大量坏死，肝细胞凋亡，部分导致结扎后的肝叶体积缩小。肝细胞凋亡在肝细胞索结构重建中起重要作用。结扎叶内Kuppfer细胞和淋巴细胞数量减少。非结扎叶中保留了Kupffer细胞的数量和功能。术前门静脉栓塞有助于提高肝切除术的安全性，扩大肝细胞癌大肝切除术的适应证。