Experimental Study Of Hepatic Blood Inflow Intermittent Occlusion Without Hepatic Artery Control

Objective Hepatic blood inflow occlusion technology is the key to the safety of hepatectomy. The experimental study with rats as the research object of HIC was established based on the unique dual blood supply of hepatic artery and portal vein.Methods The model of hepatic inflow occlusion with caudate lobe blood bypass by the professor Dong Jiahong putting forward was used in the experiment. According to the different way of blocking, the rats were randomly assigned into 3 groups: SO, IC and HTC. Tolerance limit of each group were Determinated at first time. Then the liver ischemia-reperfusion injury and regeneration in range of safe tolerant time limit hepatectomy were investigated by assessing liver blood loss,alanine aminotransferase(ALT),adenosine triphosphate(ATP),malondialdehyde(MDA),proliferating cell nuclear antigen(PCNA) and morphology changes of the rat liver in the postoperative 0d,1d,3d and 7d.Results The safe tolerant time limit of rats to both HIC group and IC group is 105 minutes.All of rats do survive on the seventh postoperativerday. After 90 min of different portal vascular clamping and hepatic left lateral lobectomy, difference was observed among the rats of the three groups. The amount of liver blood loss during hepatectomy,that of group SO was much higher than group HIC and group IC(P<0.05),and there was no difference between group HIC and group IC.At 1d and 3d postreperfusion,the ALT levels of group IC were significantly higher than those of group HIC(P<0.05),and 7 days after those of two groups were dropped to normal. The MDA and ATP levels of group IC were slighter than those of group HIC At all postreperfusion,but only at 0d postreperfusion those of group IC were much higher(P<0.05). The postoperative PCNA expression of group IC was slighter than those of group HIC. The postoperative hepatic injury of group HIC was lower than that of group IC.Conclusions The method of hepatic blood inflow intermittent occlusion without hepatic artery control could make the normal rats tolerate 105 min, and do not significantly increase blood loss in hepatectomy. Compared with intermitent pringle method,it could significantly reduce the liver ischemia-reperfusion injury and is probably beneficial to early liver regeneration in range of safe tolerant time limit hepatectomy. Thus,it is worth in the clinical application of a method into the hepatic blood inflow occlusion.