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

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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.