Establishment Of A Model Of Associating Liver Partition And Portal Vein Ligation For Staged Hepatectomy In Rats With Hepatic Cirrhosis

Objective: To establish a simple and feasible clinical animal model of ALPPS in rats with cirrhosis for exploring the possible mechanisms of liver regeneration using this technique.Method: 1. Establishment liver cirrhosis model by carbon tetr-achloride: Using carbon tetrachloride-olive oil solution which volum e fraction were 20% to 70% intraperitoneal injection twice a week for eight weeks.(20% in the first week,30% in the second week,40% in the third week, 50% in the fourth week, 60% in the fifth week,the sixth, seventh and eighth weeks were 70%); 2. Establish ALPPS model in rats: 90 cirrhosis SD rats were randomly divided into ALPPS,PVL and SHAM groups, and three different surgical treatment for each group, the left lateral lobe and the inside of the left liver lobe were deemed as remnant liver. ALPPS group: Slecti ve the portal vein ligation in rats caudate lobe, right lateral lobe, ri ght middle lobe, and papilla lobe;Then, in situ splitting along the f alciform ligament; PVL group: Slective the portal vein ligation in r ats caudate lobe, right lateral lobe, right middle lobe, and papilla l obe; SHAM group: The abdomen was closed after dissecting adhes.3. 1,3,5,7,14 days after each group of six rats were sacrificed to de tect the residual liver tissue, while weighing the whole remnant live r and liver weight.The rate of Edu positive index, weighing of the remnant liver and whole liver weight,and hepatic regeneration were assessed at 1, 3,5,7 and 14 days after the operation.Results: 1. ALPPS compared with PVL, the liver remnant wa s significantly higher than PVL at 1,3,5,7 and 14 days after the op eration(P <0.05); ALPPS compared with SHAM the liver remnant was significantly higher than SHAM at 1,3,5,7 and 14 days after th e operation(P <0.05); PVL compared with SHAM, the liver remna nt was significantly higher than SHAM at 1,3,5,7 and 14 days aft er the operation(P <0.05); 2. Both ALPPS and PVL were high E du positive index at 7 days after the operation, however, 7 days later the index began to decline. ALPPS compared with PVL, the p ositive cells of ALPPS was sig-nificantly higher than PVL, the diff erence was significant(P <0.05).3. Both ALPPS and PVL were app earing transaminase peak in the first days after the operation, then gradually declined to 7 days after basic to normal. The transaminas es was normal after theoperation at group SHAM. ALPPS compared with group PVL, the value of alanine aminotransferase were high er than PVL at 24 h after the operation, The difference was statistic ally significant(P <0.05);Both ALPPS and PVL the transaminase decreased at the 7 days aft erthe operation,but ALPPS transaminase decline faster than PVL;Conclusion: 1. SD rat was a good model with the study of liver regeneration mechanism after the step one of ALPPS. 2. ALP PS have more advantag-esthan PVL inliver regeneration in the sh ort term realization of two large liver resection,and and the impr-ov ement of liver function after operation was positively correlated wit h residual liver regeneration. 3.The first 7 days after the operation were the critical period of the remnant liver regeneration.