Journal of Liver: Disease & TransplantationISSN: 2325-9612

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Research Article, J Liver Disease Transplant Vol: 5 Issue: 3

Is faster always better? A comparative study between associating liver partition and portal vein ligation for staged hepatectomy vs classic portal vein ligation for two-stage hepatectomy in rats

Pablo Barros Schelotto1*, Luis Moulin1, Dominik Meier2, Hector Almau Trenau1, Ana Cabanne1, Valeria Descalzi1, Pablo Stringa2,3 and Gabriel Gondolesi1,3
1Liver Transplant Unit and HPB Surgery, University Hospital, Favaloro Foundation, Argentina
2Laboratory of Microsurgery and Molecular Hepatology, Favaloro University, Autonomous City of Buenos Aires, Argentina
3Institute of Translational Medicine,Transplantation and Bioengineering (IMETTYB-CONICET-Favaloro University),Argentina
Corresponding author : Pablo Barros Schelotto
Liver Transplant Unit and HPB Surgery, University Hospital, Favaloro Foundation, Argentina
Tel: 011 4378 1366
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011 4378 1392
E-mail: [email protected]
Received: December 05, 2016 Accepted: December 16, 2016 Published: December 21, 2016
Citation: Barros-Schelotto P, Moulin L, Meier D, Trenau HA, Cabanne A, et al. (2016) Is Faster Always Better? A Comparative Study between Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy vs Classic Portal Vein Ligation for Two-stage Hepatectomy in Rats. J Liver Disease Transplant 5:3doi:10.4172/2325-9612.1000144

Abstract

Background: The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been proposed to avoid liver failure after major liver resection. We thought to define the mechanism by which ALPPS enlarges liver remnant and if it is really more effective than classic two-stage hepatectomy.

Objectives: To compare if ALPPS is superior to portal vein ligation (PVL) to increase liver volume.

Methods: Sprague-Dawley rats were divided in sham, ALPPS and PVL groups. Animal weight, volumetric assessment of the liver middle lobe, mitotic index, binucleate cells index, Ki-67 index and histological evaluation were done to assess liver regeneration.

Results: No differences were found in liver volume after both procedures. (48, 65 ± 15 %, 43, 97 ± 13, 4 % and 155 ± 40 %; on 3, 7, 14 POD, for ALPPS and PVL) The liver volume/ animal weight ratios were similar in both groups. Ki67, binucleate cells and mitotic index were significantly higher in PVL and ALPPS compared with sham group, only on 3 postoperative day, (p=0.01), but were not different at the end of follow up (14 days). The histological liver damage score was slightly higher in ALPPS.

Conclusion: Both procedures are useful to achieve increases in future remnant liver volume. There is no difference in the final volume reached; observing that the increase achieved by ALPPS is faster.

 

Keywords: ALPPS; Portal vein ligation; Two staged hepatectomy; Liver regeneration

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