Comparison Between Portal Vein Branch Ligation and Embolization for Compensatory Hyperplasia of Unoccluded Hepatic Lobe

Abstract

The effect on the liver of portal vein branch embolization was examined in rabbits by measuring the hepatic tissue blood flow and cellular kinetics using the bromodeoxyuridine labeling index, compared with that of portal vein branch ligation. The rabbit liver consists of three separate masses. In our experiment, the portal vein branch to the main lobe and caudate lobe (80.4 % of the total liver weight) were ligated or embolized just above the right posterior lobe(19.6 %), resulting in compensatory hyperplasia of the right posterior lobe together with atrophy of the main lobe and caudate lobe. 24 days after operation, the weight ratio of the right posterior lobe had reached 75.8 ± 5.6 % in the ligation group. In the embolization group, however, the increase in the weight ratio stopped six days after operation, resulting that it was about 40 % thereafter. During the first three days after operation, the blood flow ratio increased significantly in the both groups compared with the sham group. However, there were no significant difference between two groups. The labeling index of the ligation group still increased significantly compared to sham group until 12th day after operation. In the embolization group, however, there were no significant difference on the 12th days after operation compared to sham group. These results suggest that portal vein branch ligation was preferable to portal vein branch embolization with regard to compensatory hyperplasia for preoperative procedure in extensive hepatobiliary surgery.