Regeneration associated pathophysiology following major hepatectomy with subsequent choledoco‐jejunostomy: A comparison with simple hepatectomy

Abstract

BackgroundThe hepatectomy with extrahepatic bile duct resection and subsequent choledoco‐jejunostomy (CJ) are often required in bile duct carcinoma. However, the impact of CJ is unknown in the liver regeneration after major hepatectomy.MethodsWe established a novel rat model, 70% hepatectomy with CJ (Hx+CJ rat). The inflammatory response and regeneration rates were evaluated in the liver using 70% hepatectomy (Hx rat) or hepatectomy with CJ (Hx+CJ rat). The gene expression was analyzed concerning inflammation and regeneration in the liver of these two groups.ResultsHistological examination revealed that progressive periportal inflammatory response in the liver of Hx+CJ rat. The hepatic regeneration rate was significantly lower in the Hx+CJ rat compared to the Hx rat on days 2 and 4 after surgery. The expression of inflammation‐associated genes was higher in the liver of the Hx+CJ rat than the Hx rat. The regeneration‐associated genes, such as hepatocyte growth factor and epidermal growth factor were significantly lower in the Hx+CJ rat than the Hx rat.ConclusionThese results showed that CJ impairs the liver regeneration after major hepatectomy. CJ induce the progressive periportal inflammation in the liver. The inflammation partly causes the suppression of regeneration‐associated genes in the liver.