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World J Gastroenterol. Jan 28, 2014; 20(4): 1021-1029
Published online Jan 28, 2014. doi: 10.3748/wjg.v20.i4.1021
Published online Jan 28, 2014. doi: 10.3748/wjg.v20.i4.1021
Portal inflow preservation during portal diversion in small-for-size syndrome
Xian-Qiang Wang, Department of Hepatobiliary Surgery, Qilu Hospital, Shandong University, Jinan 250012, China
Xian-Qiang Wang, Wen-Ping Lv, Zhe Liu, Jian-Ping Zeng, Jia-Hong Dong, Department of Hepatobiliary Surgery, the Chinese PLA General Hospital, Beijing 100853, China
Yue-Fang Xu, Department of Pharmacology, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing 100048, China
Jing-Wang Tan, Department of Hepatobiliary Surgery, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing 100048, China
Author contributions: Wang XQ and Dong JH conceived and designed the experiments; Wang XQ, Tan JW and Xu YF performed the experiments; Lv WP, Liu Z and Zeng JP analyzed the data; Wang XQ and Tan JW wrote the paper; all the authors have read and approved the final manuscript to be published.
Supported by Chinese Ministry of Health, China, No. 200802012, the Project of National Natural Science Foundation of China, No. 81271738; and the National Science and Technology Major Project, No. 2012BAI06B01
Correspondence to: Jia-Hong Dong, MD, PhD, FACS, Department of Hepatobiliary Surgery, the Chinese PLA General Hospital, Beijing, China. dongjh_301@163.com
Telephone: +86-10-66938030 Fax: +86-10-66848636
Received: April 3, 2013
Revised: July 23, 2013
Accepted: September 4, 2013
Published online: January 28, 2014
Revised: July 23, 2013
Accepted: September 4, 2013
Published online: January 28, 2014
Core Tip
Core tip: We established a model of small-for-size syndrome in pigs undergoing 85%-90% hepatectomy with mesocaval shunt (MCS) placement to define the optimal portal inflow required to preserve liver regeneration. Our findings indicate that diversion of portal inflow by MCS reduces injury from portal overflow following major hepatectomy, whereas excessive diversion of portal flow can retard liver regeneration. Preservation of portal inflow to at least 3.2 times above baseline levels appeared to promote hepatocyte hypertrophy and reduce apoptosis.