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World J Gastroenterol. Aug 21, 2013; 19(31): 5076-5084
Published online Aug 21, 2013. doi: 10.3748/wjg.v19.i31.5076
Published online Aug 21, 2013. doi: 10.3748/wjg.v19.i31.5076
Impact of mesocaval shunt on safe minimal liver remnant: Porcine model
Yu-Liang Tu, Da-Dong Wang, Zi-Man Zhu, Jing-Wang Tan, Department of Hepatobiliary Surgery, the First Affiliated Hospital, Chinese PLA General Hospital, Beijing 100048, China
Xuan Wang, Department of Hepatobiliary Surgery, Chinese PLA No. 81 Hospital, Nanjing 210002, Jiangsu Province, China
Author contributions: Tu YL and Tan JW performed the majority of the experiments; Wang X, Wang DD and Zhu ZM provided vital reagents and analytical tools, and were also involved in editing the manuscript.
Correspondence to: Jing-Wang Tan, Professor, Department of Hepatobiliary Surgery, the First Affiliated Hospital, Chinese PLA General Hospital, No. 51, Fucheng Road, Beijing 100048, China. tuyul76@163.com
Telephone: +86-10-66848634 Fax: +86-10-66848636
Received: February 22, 2013
Revised: June 28, 2013
Accepted: July 9, 2013
Published online: August 21, 2013
Revised: June 28, 2013
Accepted: July 9, 2013
Published online: August 21, 2013
Core Tip
Core tip: When the residual liver volume is extremely small after extended hepatectomy or living-donor liver transplantation, postoperative hepatic failure (PHF) or small-for-size syndrome (SFSS) may result from portal hypertension or hyperperfusion. We demonstrated that mesocaval shunt attenuated portal overflow injury, however, it is unknown how much the shunt can decrease, and whether the shunt can do the same for small liver remnants following subtotal hepatectomy. We showed that the residual volume was the determinant factor of PHF or SFSS after subtotal hepatectomy, and the shunt attenuated injury from hyperperfusion, and made marginal hepatectomy safer.