Effect of splenectomy on liver regeneration and function following partial hepatectomy: experimental study

ABSTRACT

The presence of enough remaining functioning liver parenchyma to avoid life-threatening postoperative liver failure is a major prerequisite for hepatic resection in patients with hepato biliary carcinoma. There are clinical reports which confirm the beneficial clinical effects of splenectomy on integrity of the residual liver following liver resection for hepatocellular carcinoma in cirrhotic patients with hypersplenism and portal hypertension. This experimental study was designed on hamsters to evaluate the proliferative capacity and function of the remaining liver lobes; in which splenectomy was done simultaneously with partial hepatectomy compared with those in which splenectomy was not done. Forty hamsters were divided into two groups GI; in which partial hepatectomy was performed without splenectomy and the GIl; in which animals were subjected to partial hepatectomy with prior splenectomy. Animals from each group were subjected to liver biopsy from the remaining lobes 48, 72 hours and one week after surgery. Also, serum alanine aminotransferase [ALT] and total bilirubin were tested before, 48, 72 hours and one week after hepatectomy. Hepatic regeneration in the remaining lobes was assessed through histo-pathological study, DNA ploidy of the hepatic nuclei using computerized image analysis system and determining of the labeling index of the nuclear factor NF Kappa B [P105], a novel monoclonal antibody specific for P105 protein by immunohistochemistry. In GIl induction of NK kappa B [PI05] labeling index showed maximum expression depending on the regenerative capacity of the remaining liver lobes. In contrast, in GI; liver regeneration was slow. Also, changes in liver function of Gil indicated that splenectomy prior hepatecotomy may minimize dysfunction in the remaining hypertrophied liver lobes