Effects of Right Hepatic Artery Ligation

Abstract

Background: Injury to right hepatic artery (RHA) may occur during hepatobiliary operative procedures. Although it may not be detected and is clinically silent in most of the cases, liver abscess, bleeding, hemobilia, and right hepatic lobe ischemia needing surgical excision have been reported. The aim of this study was a more detailed evaluation of hepatic consequences following RHA injury in an animal model. Methods: This study was conducted on 20 New Zealand rabbits 6 months of age. Blood samples for the measurement of hepatic enzymes was obtained from the rabbits before ligation of the hepatic artery. After 10 days, blood sampling was repeated and the animals were killed and 0.5 × 2 cm liver wedge biopsy was prepared from right lateral lobe, the distribution area of RHA. P values of < 0.05 were considered significant. Results: Laboratory data before and after surgical intervention showed serum bilirubin of 0.133 ± 0.044 and 0.135 ± 0.042, respectively (P value = 0.47). Serum alkaline phosphatase (ALP) was 122.4 ± 44.12 and 122.8 ± 44.43, (P value = 0.36) respectively. Serum glutamic-pyruvic transaminase (SGPT) was 31.2 ± 5.34 and 86.2 ± 33.9, (P value = 0.001) respectively. Serum glutamic oxaloacetic transaminase (SGOT) was 30.13±8.46 and 69.4±47.7, respectively (P value = 0.001). Laparotomy showed no considerable change in median lobe of livers, except mild necrosis in one (5%) rabbit. Severe necrosis was found in the right lateral lobe of 15 rabbits (75%), moderate necrosis in 3 (15%), and mild necrosis in 2 (10%) cases. No abscess or gangrene was found. The Gall bladder was intact in all animals. Conclusions: The RHA obliteration causes an increase in liver enzymes and considerable right lateral hepatic lobe necrosis (75%) but no liver abscess, gangrene or gall bladder abnormality