Experimental study to establish new therapeutic method for liver cancer with hepatic cirrhosis-gradual interruption of hepatic blood flow

建立肝癌合并肝硬化治疗新方法的实验研究——逐步阻断肝血流

• 批准号: 04670768
• 负责人: SHIMODA Mitsuyoshi
• 金额: $ 1.22万
• 依托单位: Toyama Medical & Pharmaceutical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1992
• 资助国家: 日本
• 起止时间: 1992 至 1993
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-04670768/
• 关键词: Portal branch ligation; Gradual occlusion; SD activity; MTT assay; ICG Rmax; Liver tissue blood flow; Hepatectomy; Ameroid constrictor

For the surgical treatment of unresectable hepatic tumor, we devised a new method whereby portal branch ligation with gradual occlusion of hepatic arterial branch by ameroid constrictor.We investigated the possibility of clinical application of this new therapeutic method using forty-four mongrel dogs. Experimental group was designed as follows. Group A ; sham operation (n=6). Group B ; 70 percent hepatectomy (n=10). Group C ; 70 percent of the liver was deprived of portal blood flow by portal branch ligation (n=15). Group D ; portal branch ligation with gradual occlusion of hepatic arterial branch which supplying about 70 percent of the liver (n=13). In A, B and C group, one dog died of infection and hepatic necrosis, respectively. In group D, one dog died on eighth post operative day (but we could not find the evidence of hepatic necrosis). During eight weeks, we observed the changes of hepatic function test including ICG Rmax. Hepatic tissue blood flow (Laser Doppler Verocimetry) an … More d viability of isolated hepatocytes (MTT assay) was measured at the time of operation and sacrifice (eight weeks after initial operation).Marked increase of serum GOT and GPT level was observed in group D (maximum, >10,000 U/I), although the changes in ICG Rmax were almost the same as group C, and the surgical stress was less than hepatectomy group. In group C and D, the viability of hepatocytes of non occluded lobes were significantly higher than occluded ones (P<0.001). In group d, the viability of non occluded lobes was significantly higher than preoperative value (p<0.01). In group D the occuluded lobes showed atrophy and focal necrosis, and non occluded lobes showed regeneration and hypertrophy. Comparing with group C and B, hypertrophy and regeneration seemed greater in group D (even in occluded lobes, hypertrophy of hepatocytes was noted). These findings indicate the possibility of clinical application not only as anti cancer therapy, but also as preoperative treatment that increases remnant hepatic reserve function. Less

为探讨门静脉分支结扎加肝动脉分支逐渐阻断的新方法在治疗不能切除的肝肿瘤中的临床应用价值，用44只杂种狗进行了实验研究。实验组设计如下。A组：假手术组（n=6）。B组：70%肝切除术（n=10）。C组：门静脉分支结扎，阻断70%肝门血流（n=15）。D组：门静脉分支结扎，逐渐阻断肝动脉分支（约占肝脏的70%）（n=13）。A、B、C组分别有1只犬死于感染和肝坏死。D组1只犬于术后第8天死亡（未发现肝坏死）。八周内观察肝功能检查包括ICG Rmax的变化。肝组织血流量（激光多普勒血流仪）和 ...更多信息 D组血清GOT、GPT水平明显升高（最高> 10，000 U/I），ICG Rmax变化与C组基本相同，手术应激程度低于肝切除组。C组和D组未闭塞肝叶的肝细胞活力明显高于闭塞肝叶（P<0.001）。d组未闭塞肺叶的存活率明显高于术前（p<0.01）。D组闭塞叶呈萎缩、局灶性坏死，非闭塞叶呈增生、肥大。D组与C、B组比较，肝细胞肥大和再生程度明显增加（即使在闭塞的肝叶，也可见肝细胞肥大）。这些结果表明，临床应用的可能性，不仅作为抗癌治疗，而且作为术前治疗，以提高残余肝储备功能。少