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Bile Acid Overload Induced by Bile Duct and Portal Vein Ligation Improves Survival after Staged Hepatectomy in Rats

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Abstract

Objective

Compared to portal vein ligation (PVL), simultaneous bile duct and portal vein ligation (BPL) can significantly enhance hypertrophy of the intact liver. This study aimed to investigate whether BPL could improve survival after extended hepatectomy independently of an increased remnant liver.

Methods

We adopted rat models of 90% BPL or 90% PVL. To investigate the role of bile acids (BAs) the BA pools in the PVL and BPL groups were altered by the diet. Staged resection preserving 10% of the estimated liver weight was performed 3 days after BPL; PVL; or sham operation. Histology, canalicular network (CN) continuity; and hepatocyte polarity were evaluated.

Results

At 3 days after BPL; PVL; or sham operation when the volumetric difference of the intended liver remained insignificant, the survival rates after extended hepatectomy were 86.7%, 47%, and 23.3%, respectively (P<0.01). BPL induced faster restoration of canalicular integrity along with an intensive but transient BA overload. Staged hepatectomy after BPL shortened the duration of the bile CN disturbance and limited BA retention. Decreasing the BA pools in the rats that underwent BPL could compromise these effects, whereas increasing the BA pools of rats that underwent PVL could induce similar effects. The changes in CN restoration were associated with activation of LKB1.

Conclusion

In addition to increasing the future remnant liver, BPL shortened the duration of the spatial disturbance of the CN and could significantly improve the tolerance of the hypertrophied liver to staged resection. BPL may be a safe and efficient future option for patients with an insufficient remnant liver.

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Author notes

  1. The authors contributed equally to this work.

Authors and Affiliations

  1. Faculty of Hepato-Pancreato-Biliary Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China

    Xin-lan Ge, Xuan Zhang, Chong-hui Li, Ke Pan, Lei He & Wei-zheng Ren

  2. Institute of Hepatobiliary Surgery of Chinese PLA, Beijing, 100853, China

    Xin-lan Ge, Xuan Zhang, Chong-hui Li, Ke Pan, Lei He & Wei-zheng Ren

  3. Key Laboratory of Digital Hepatobiliary Surgery, PLA, Beijing, 100853, China

    Xin-lan Ge, Xuan Zhang, Chong-hui Li, Ke Pan, Lei He & Wei-zheng Ren

Authors
  1. Xin-lan Ge
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  2. Xuan Zhang
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  3. Chong-hui Li
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  4. Ke Pan
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  5. Lei He
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Correspondence to Lei He or Wei-zheng Ren.

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The authors declare that they have no conflicts of interest.

Additional information

This work was supported by the Natural Science Foundation of Beijing Municipality (No. 7194317).

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Ge, Xl., Zhang, X., Li, Ch. et al. Bile Acid Overload Induced by Bile Duct and Portal Vein Ligation Improves Survival after Staged Hepatectomy in Rats. CURR MED SCI 43, 1013–1022 (2023). https://doi.org/10.1007/s11596-023-2779-5

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  • DOI: https://doi.org/10.1007/s11596-023-2779-5

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