| Objective: ALPPS is a new surgical method used to solve the problem of insufficient liver volume in patients with partial hepatectomy.Due to its unique rate of proliferation,it is regarded by many clinicians as he effective methods to the clinical problems of hepatectomy in the future solution endoplasmic reticulum stress plays an important role in cell growth,proliferation,apoptosis,etc.Therefore,the study of endoplasmic reticulum stress in combined liver segmentation and portal vein ligation two-step hepatectomy(ALPPS)The role of liver regeneration after surgery is necessary.Method: Seventy-two C57bl/6 mice were randomly divided into ALPPS group,portal vein ligation(PVL)group and sham operation group.ALPPS one-stage operation,simple PVL and sham operation,the median incision was taken to open the abdominal cavity,the falciform ligament and the hepatogastric ligament were dissected,the liver was fully exposed,the left lobe of the liver was ligated,and the caudate,right and middle lobe arteries,bile ducts and portal vein branches were carefully separated.The sham operation group After the above operation,the abdomen was sutured layer by layer.On the basis of this,the PVL group sequentially ligated the tail vein,the right lobe,and the right middle lobe corresponding to the portal vein branch,and retained the left middle lobe artery,the bile duct and the portal vein branch.On the basis of this,t he ALPPS group disconnected the liver parenchyma along the ischemic line of the middle lobe and fully stopped the bleeding with a unipolar electrosurgical knife.Finally,hemostatic gauze was placed on the section to prevent bleeding and postoperative adhe sion.After suture,4-0 silk suture was used.The residual liver weight was weighed after 1? 2?4 and 7 days after operation.The liver regeneration rate of each group was calculated.The expression level of Ki67 in each group was detected by immunohistochemistry to reflect the proliferation of hepatocytes.The protein expression level of IRE1?-XBP1 was detected by WB to reflect the level of endoplasmic stress at each time point.Results: Compared with the sham operation group,the ALPPS group and the PVL group showed a trend of increasing liver residual volume on the second day after surgery,and the proliferation rate of the two groups increased significantly on the 4th and 7th day after surgery,while the result in ALPPS group was greater than that of PVL group on the 4th and 7th day.(p<0.05);Ki67 positive rate increased significantly on the 2nd day after operation in the ALPPS group and the PVL group,surprisingly,it increased significantly on the 4th day.Furthermore,the positive rate of Ki67 in the ALPPS group was significantly higher than that in the PVL group on the 2nd and 4th day after surgery(p<0.05);The expression of XBP-1 was distinctly observed in the liver tissues of the ALPPS group and the PVL group,but the expression of XBP-1 was more significant in the ALPPS group at 2?4and 7 days after surgery.Conclusions: ALPPS-induced liver regeneration is more advantageous than traditional PVL in mice,and it shows more obvious endoplasmic reticulum stress.The proliferative trend increases from the second day after surgery.Most encouragement on Day 7,mechanism leading to such a difference may be the more obvious regulation of endoplasmic reticulum stress activation and related mechanisms after ALPPS,which promoted more hepatocytes to enter the cell cycle and promoted rapid liver regeneration. |
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