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How to successfully resect 70 % of the liver in pigs to model an extended hepatectomy with an insufficient remnant or liver transplantation with a small-for-size graft

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Abstract

An insufficient remnant in extended hepatectomy and small-for-size graft in liver transplantation are critical matters in the field of liver surgery, and reliable and reproducible animal models that can provide clinically relevant and reliable data are needed. We herein describe our detailed surgical procedures for performing 70 % hepatectomy in pigs, and discuss the critical anatomical features, key techniques and pitfalls based on our experience. The porcine liver is divided into four lobes. The right lateral lobe (RLL) accounts for 30 % of the liver volume. Important points, such as selective temporal clamping of the arterial branch, confirmation of a related demarcation line, a two-step process to skeletonize Glisson’s capsules during liver resection and selective ligation of the portal venous branch to the right medial lobe without inducing any subtle injuries to Glisson’s capsules from the RLL to common bile duct, are discussed.

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Acknowledgments

We are grateful to Kentaro Taniguchi, Chiduru Yamamoto, Reo Sakakura and Kenji Nakamura (First Department of Surgery, Mie University Graduate School of Medicine, Tsu, Japan) for their support in establishing this model. This work was partially supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science, Tokyo, Japan (MEXT/JSPS 24591877 to S. Yagi) and by a grant from the Uehara Memorial Foundation, Tokyo, Japan (No. 200940051 to T. Hori).

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None of the authors has any financial conflict of interest to declare.

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Correspondence to Tomohide Hori.

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Hori, T., Yagi, S., Okamua, Y. et al. How to successfully resect 70 % of the liver in pigs to model an extended hepatectomy with an insufficient remnant or liver transplantation with a small-for-size graft. Surg Today 44, 2201–2207 (2014). https://doi.org/10.1007/s00595-014-0862-z

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