INFLUENCE OF RESECTION OF DIFFERENT VOLUMES OF LIVER PARENCHYMA ON ITS BILE-FORMING FUNCTION
DOI:
https://doi.org/10.11603/mcch.2410-681X.2019.v.i3.10559Keywords:
liver resection, bile formation, bile excretionAbstract
Introduction. Liver resection is widely performed in clinics today. Removal of large amounts of liver leads to various postresection complications and to changes of bile formation.
The aim of the study – to learn the peculiarities of bile-forming function of liver in resection of various volumes of its parenchyma.
Research Methods. The research was conducted on 45 male lab rats, which were divided into 3 groups. Group 1 consisted of 15 intact animals, group 2 – 15 rats after resection of 31.5 % of liver parenchyma, group 3 – 15 animals after removal of 58.1 % of the volume of liver. In 1 month after the beginning of the experiment under thiopental anesthesia, the common bile duct was catheterised and the bile was taken for 1 hour. Intensity of bile secretion was calculated, concentration of bile acids: taurocholic, glycocholic, cholic, chenodeoxycholic + deoxycholic, content of phospholipids, free fatty acids, triglycerides and proteins were determined. Euthanasia of experimental animals was carried out via bloodletting under thiopental anesthesia in a month from the beginning of the experiment. Histologic micronutrients of the liver were studied light-optically. Quantitative indicators were processed statistically.
Results and Discussion. Resection of 58.1 % of liver parenchyma led to postresection portal hypertension, which is characterized by enlargement of the hepatic portal vein, plethora with dilatation of mesentery veins, venous vessels of the small and large intestines, ascites, splenomegaly. The intensity of bile secretion decreased by 28.9 % compared to the control, the concentration of taurocholic acid decreased by 21.5 %, glycocholic – by 15.56 %, cholic – by 18.6 %, and chenodeoxycholic+deoxycholic – by 16.2 %, the concentration of phospholipids decreased by 11.0 %, free fatty acids – by 10.4 %, triglycerides – by 19.8 %, and proteins – by 8.02 %. Light-optically there was a plethora of venous vessels, areas of hepatocytes hypertrophy and dystrophy, the appearance of lymphoid-hystiocytic infiltrates and increased stromal structures in micropreparations of the liver in group 3.
Conclusion. Resection of the left and right lateral lobes of liver leads to postresaction portal hypertension and changes in bile formation and bile excretion, which is characterized by a decrease in the intensity of bile secretion, decrease in the amount of bile acids, phospholipids, free fatty acids, triglycerides and proteins.
References
Vishnevskiy, V.A., Efanov, M.G., & Kazakov, I.V. (2012). Segmentarnye rezektsii pecheni, otdalennye rezultaty pri zlokachestvennykh opukholyakh pecheni [Segmental resections of liver, long-term results in malignant tumors of liver]. Ukr. Zhurnal Khirurhii – Ukainian Journal of Surgery, 1(16), 5-15 [in Russian].
Fedorov, V.D., Vishnevskiy, V.A., Nazarenko, N.A., Ikramov, R.Z., & Kozyrin, I.A. (2007). Osnovnye oslozhneniya obshyrnykh rezektsiy pecheni i puti ikh preduprezhdeniya [The main complications of extensive liver resections and ways to prevent them]. Byull. sibirskoy meditsyny – Bulletin of Siberian Medicine, 4, 16-24 [in Russian].
Kotenko, O.H., Kalyta, M.Ya., Hrynenko, O.V., Popov, O.O., Korshak, O.O., & Husev, A.V. (2012). Rezultaty khirurhichnoho likuvannia hepatotseliuliarnoi kartsynomy z pukhlynnym trombozom voritnoi veny [Results of surgical treatment of hepatocellular carcinoma with tumorous vein thrombosis]. Halytskyi likars. visnyk – Galician Medicinal Herald, 19 (3), 69-71 [in Ukrainian].
Rahbari, N.N., Garden, O.J., & Padbury, R. (2011). Posthepatectomy liver failure: a definition and grading by the international study group of liver surgery. Surgery, 149, 713-724.
Mogilevets, E.V., Gorelik, P.V., & Dubrovshchik, O.I. (2018). Portalnaya gipertenziya, oslozhnennaya krovotecheniem iz varikozno rasshirennykh ven pishchevoda i zheludka: sovremennoye sostoyanie problemy lecheniya i profilaktiki [Portal hypertension, complicated by bleeding from varicose veins of the esophagus and stomach: the current state of the problem of treatment and prevention]. Ukr. Zhurn. Khіrurgіi – Ukainian Journal of Surgery, 1 (36), 67-72 [in Russian].
Hudyma, A.A., & Yarema, V.V. (2012). Porushennia zhovchoutvorennia i zhovchovydilennia v rannii period politravmy u tvaryn z riznoiu metabolizuvalnoiu zdatnistiu pechinky [Violation of bile formation and bile excretion in the early period of polytrauma in animals with different metabolic capacity of the liver]. Zdobutky klin. i eksperyment. medytsyny – Achievements of Clinical and Experimental Medicine, 2 (17), 48-54 [in Ukrainian].
Masyuk, A., Veselsky, S., & Tukaev, S. (1997). The comparative study of the action of noradrenaline and other [Ca2+] regulating agents on bile secretion. Liver and Nervous System. Falk Symposium № 103. Freiburg (Germany), 2, 56.
Drogovoz, S.M., Salnikova, S.I., Skakun, N.P. & Slyshkov, V.V. (1994). Metodicheskie rekomendatsii po eksperimentalnomu izucheniyu zhelchegonnoy, kholespazmoliticheskoy, kholelitiaznoy i gepatoprotektornoy aktivnosti novykh lekarstvennykh sredstv [Guidelines for the experimental study of the choleretic, cholespasmolytic, cholelithiasis and hepatoprotective activity of new drugs]. Kyiv: FK MZ Ukrainy [in Russian].
Ganitkevich, Ia.V., & Karbach, Ya.I. (1995). Issledovanie zhelchi. Biokhimicheskie i biofizicheskie metody [The study of bile. Biochemical and biophysical methods]. Kyiv: Vyshcha shkola [in Russian].
Reznikov, O.H. (2003). Zahalni etychni pryntsypy eksperymentiv na tvarynakh [General ethical principles of experiments on animals]. Endokrynolohiia – Endocrinology, 1 (8), 142-145 [in Ukrainian].
Lapach, S.N. Chubenko, A.V., & Babich, P.N. (2001). Statisticheskiye metody v mediko-biologicheskikh issledovaniyakh s ispolzovaniem Excel [Statistical methods in biomedical research using Excel]. Kyiv: Morion [in Ukrainian].
Hnatiuk, M.S., Tatarchuk, L.V., & Yasinovskyi, O.B. (2016). Morfometrychna otsinka osoblyvostei remodeliuvannia struktur dvanadtsiatypaloi kyshky pry rezektsii riznykh obiemiv pechinky [Morphometric evaluation of the peculiarities of duodenal structures remodeling in resection of various liver volumes]. Naukovyi visnyk Uzhhorodskoho universytetu. Seriia “Medytsyna” – Scientific Journal of Uzhhorod University. Series “Medicine, 1 (53). 92-95 [in Ukrainian].
