Abstract
Background: One of the major problems associated with liver resection is the development of liver failure after surgery. It was thought to be related to the ischaemic insult induced to the remnant liver at the time of the hilar inflow occlusion during liver resection. Ischaemic preconditioning, however, has been shown to be effective in other organ systems to prevent ischaemic and also ischaemic-reperfusion injury. In this study, we tested if ischaemic preconditioning can protect cirrhotic liver from ischaemic insult during liver resection. Methods: Wistar Furth rats were induced to develop liver cirrhosis by thrice weekly injection of thioacetamide intraperitoneally for 8 weeks. Ischaemic preconditioning is induced by 10 min of hilar clamping followed by 15 min of unclamping. Rats were then randomized into two groups of either with or without ischaemic preconditioning. The rats were then subjected to either 15 or 30 min of hilar clamping followed by 60 per cent hepatectomy. Results: Conclusion: Our data suggest that ischaemic preconditioning is a useful procedure to protect the cirrhotic rats from dying after a 60 per cent liver resection. Further studies in the mechanisms of the protection would offer more information before we can apply this manoeuvre in clinical practice.
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