Effects Of ALPPS On Liver Regeneration Of Rat With Liver Cirrhosis

Objective To observe the efficacy of associating liver partition with portal vein ligation for staged hepatectomy(ALPPS)on liver regeneration of the unligated lobe with cirrhosis.Methods 60 cirrhosis SD rats were randomly divided into three groups : group C-ALPPS(n=20,liver cirrhosis+ALPPS),group C-PVL(n=20,liver cirrhosis+PVL),group C-Sham(n=20,liver cirrhosis+sham operation).60 normal SD rats were randomly divided into three groups:group N-ALPPS(n=20,normal liver+PVL),group N-PVL(n=20,normal liver+PVL);group N-Sham(n=20,normal liver+sham operation).The weight ratio of unligated lobes/total liver,proliferating cell nuclear antigen(Ki-67),alanine transaminase(ALT),aspartate aminotransferase(AST)and albumin(ALB)levels were compared before operation and 2nd,4th and 7th day after operation.Results The weight ratio unligated lobes/total liver in the cirrhosis group except the sham operation group were lower than that in the normal group at 4th and 7th day after operation.The weight ratio unligated lobes/total liver in group C-ALPSS and group NALPPS at 4th and 7th day postoperation were(54.26±3.07)% VS(61.19±2.10)% ?(65.01±4.09)%VS(79.21±1.12)%,and the weight ratio unligated lobes/total liver in group C-PVL and group N-PVL at 4th and 7th day postoperation were(52.38±1.78)%VS(56.61±2.01)%?(63.78±3.08)%VS(70.02±2.54)%,.There was no significant difference in weight ratio unligated lobes/total liver between C-ALPPS group and C-PVL group at each time point(P <0.05).There was significant difference in the ALT,AST and ALB levels between cirrhosis group and normal group at 4th and 7th day after operation(P <0.05).The expression level of Ki-67 in cirrhosis group was significantly lower than that in normal group at each time point(P <0.05).The expression level of Ki-67 in group C-ALPSS and group N-ALPPS at 2nd,4th and 7th day postoperation were(19.36±4.76)%VS(84.13±8.93)%?(33.63±3.53)%VS(70.24±7.24)%?(20.23±2.52)%VS(50.74±4.35)%,and the expression level of Ki-67 in group CPVL and group N-PVL at 2nd,4th and 7th day postoperation were(21.05±4.02)%VS(52.14±7.27)%?(32.35±5.89)%VS(35.59±5.31)%?(15.48±4.64)%VS(12.23±4.85)%.There was no significant difference of Ki-67 levels between C-PVL group and C-ALPPS group at 2nd and 4th day after operation(P <0.05).Conclusion In normal rats,the liver regeneration rate after ALPPS was significantly higher than that after PVL.The liver regeneration rate after ALPPS in cirrhotic rats was significantly lower than that in normal rats after ALPPS.There was no significant difference of the liver regeneration rate between ALPPS and PVL in cirrhotic rats.