Analysis of hepatic reserve function after extended hepatectomy and treatment of acute liver failure induced by extended hepatectomy

扩大肝切除术后肝脏储备功能分析及扩大肝切除所致急性肝功能衰竭的治疗

• 批准号: 16591332
• 负责人: KAI Masahiro
• 金额: $ 2.11万
• 依托单位: University of Miyazaki
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2004
• 资助国家: 日本
• 起止时间: 2004 至 2005
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-16591332/
• 关键词: extended hepatectomy; liver failure; organic anion transporter; obstractive jaundice; bile acid

Extended hepatectomy for advanced biliary cancer may result in acute liver failure even if in patients with normal liver function. Preoperative and postoperative evaluation of hepatic reserve function especially in patients with liver cirrhosis or obstructive jaundice, to prevent postoperative liver failure, is very important.1.The changes of mRNA expression of the organic anion transporters (mrp2, mrp3, bsep, oatp and ntcp) depending on the duration of bile duct ligation have been examined in rats. Blood and liver tisues were obtained during the period from 3 to 28 days after the ligation. The excretion transporters, the mRNA levels of mrp2 and bsep decreased, while those of mrp3 increased from 3 days until 28 days after the ligation. The uptake transporters, ntcp and oatp decreased until 28 days after the ligation. After 7 days ligation of bile duct, external and internal biliary drainage were performed. The expression of mrp2 mRNA levels increased, while those of mrp3 decreased. The … More se changes of mrp2 and mrp3 mRNA expressions were significantly stronger in the internal biliary drainage than the external drainage. These suggest that the internal biliary drainage is useful for hepatic function reserve. We are now examining the expression of these protein levels.2.We evaluated the differences in hepatic reserve function and parameters to predict the liver failure in the early stage after extended hepatectomy in rats. The survival rates of 48 hours after hepatectomy were 50% in 90% hepatectomy and 100% in 70% hepatectomy. 90% hepatectomy is a model for acute liver failure. We determined the bile flow, biliary bile acid excretion and the mRNA levels of organic anion transporters (mrp2, mrp3 and bsep) after 70% or 90% hepatectomy in rats. The bile flow and bile acid excretion both decreased significantly after the 90% hepatectomy. Biliary bile acid excretion and the expression of mrp2 decreased, while the expressions of mrp3 and bsep increased after 90% hepatectomy. In contrast, the expression of mrp2 increased, while the expressions of mrp3 and bsep decreased after 70% hepatectomy. The expressions of mrp2 and mrp3 were differently regulated after 70% and 90% hepatectomy. We suspected that expressions of mrp2 and mrp3 and biliary bile acid excretion and bile flow might be able to predict the liver failure after extended hepatectomy. Less

晚期胆道癌的扩大肝切除术可能导致急性肝功能衰竭，即使在肝功能正常的患者中也是如此。术前、术后评估肝储备功能，特别是对有肝硬变或梗阻性黄疸的患者，对于预防术后肝功能衰竭非常重要。1.观察了大鼠胆管结扎后不同时间有机阴离子转运体(mrp2、mrp3、bsep、oatp和ntcp)mRNA表达的变化。于结扎后3~28d取血和肝组织。排泄转运蛋白mrp2和bsep的表达水平在结扎后3d开始下降，而mrp3的表达在3d至28d逐渐升高。摄取转运体ntcp和oatp在结扎后28d下降。术后7d结扎胆管，行胆道外引流和内引流。Mrp2基因表达水平升高，mrp3基因表达水平降低。The…胆道内引流较外引流mrp2、mrp3基因表达的改变更明显。提示胆道内引流有利于肝功能储备。我们正在检测这些蛋白水平的表达。2.我们评估了肝储备功能和参数的差异，以预测大鼠扩大肝切除术后早期肝功能衰竭。肝切除后48h存活率，90%肝切除组为50%，70%肝切除组为100%。90%肝切除是急性肝功能衰竭的一种模型。我们测定了大鼠70%和90%肝切除后胆汁流量、胆汁酸排泄量和有机阴离子转运体(mrp2、mrp3和bsep)的mRNA水平。90%肝切除后胆汁流量和胆汁酸排泄量均明显减少。90%肝切除后胆汁中胆汁酸排泄量和mrp2表达减少，mrp3和bsep表达增加。相反，70%肝切除后mrp2表达增加，mrp3和bsep表达降低。70%和90%肝切除后，mrp2和mrp3的表达受到不同程度的调节。我们推测mrp2和mrp3的表达以及胆汁中胆汁酸的排泄和胆汁流量可能能够预测扩大肝切除术后的肝功能衰竭。较少

项目成果

Risk factors for early death after liver resection in patients with solitary hepatocellular carcinoma

• DOI: 10.1007/s00534-005-1009-9
• 发表时间: 2005-01-01
• 期刊: JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY
• 作者: Kondo, K;Chijiiwa, K;Naganuma, S
• 通讯作者: Naganuma, S

Prognostic benefit of selective portal vein occlusion during hepatic resection for hepatocellular carcinoma

• DOI: 10.1016/j.surg.2005.02.008
• 发表时间: 2005-06-01
• 期刊: SURGERY
• 影响因子: 3.8
• 作者: Makino, I;Chijiiwa, K;Kai, M
• 通讯作者: Kai, M

Biliary Lipid Output in the Early Stage of Acute Liver Failure Induced by 90% Hepatectomy in the Rat

胆汁%20脂质%20输出%20in%20the%20早期%20阶段%20of%20急性%20肝脏%20失败%20诱导%20by%2090%%20肝切除%20in%20the%20Rat

• 发表时间: 2006
• 期刊: Journal of Surgical Research 134
• 作者: Tanaka;S.-I.;Chiiiiwa;K.;Maeda;Y
• 通讯作者: Y

Biliary lipids output in the early stage of acute liver failure induced by 90% hepatectomy in the rat

胆道%20脂质%20输出%20in%20the%20早期%20阶段%20of%20急性%20肝脏%20失败%20诱导%20by%2090%%20肝切除%20in%20the%20rat

• 发表时间: 2006
• 期刊: Journal of Surgical Research (in press)
• 作者: Tanaka;S.-I.;Chijiiwa;K.;Maeda;Y.
• 通讯作者: Y.