• Title/Summary/Keyword: hepatectomy

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The Effect of Gamisoyo-san Intravenous Pharmacopuncture on Restoration of Liver Function after Partial Hepatectomy in SD Rat (가미소요산 혈맥약침이 부분 간절제술을 시행한 Rat의 간기능 회복에 미치는 영향)

  • Lee, Chan;Yun, Jung-Hun;Yim, Yun-Kyoung
    • The Journal of Korean Medicine
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    • v.36 no.1
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    • pp.22-32
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    • 2015
  • Objectives: This study researched the effect of Gamisoyo-san intravenous pharmacopuncture on restoration of liver function after partial hepatectomy in SD rat. Methods: Twelve rats were randomly divided into three groups: control group (n=4) underwent partial hepatectomy, saline group (n=4) was injected $1m{\ell}$ saline after partial hepatectomy, Gamisoyo-san group (n=4) was injected with 10mg/kg Gamisoyo-san after partial hepatectomy. Liver function and liver regeneration ratio were measured on the seventh day after partial hepatectomy. Results: The results show that the AST, AST and ALT level in Gamisoyo-san group was significantly lower than those of control group and saline group(P<0.05) Conclusion: In partial hepatectomy model, Gamisoyo-san intravenous pharmacopuncture seems to significantly promote the restoration of liver function.

Activity Change of Ornithine Decarboxylase(ODC) after Hepatectomy

  • Chang Sung;Jou, Kab-Yeo;Ha, Duk-Mo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.3
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    • pp.415-419
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    • 1995
  • Ornithine decarboxylase(ODC) catalyzes the first and key step in the polyamine biosynthetic pathway. Ornithine decarboxylase is known to the enzyme that increase substantially its activity in regenerating liver. We found that activity and mRNA level for ODC increase significantly after partial hepatectomy in the rat. After laparotomy, there was significant decrease in activity ; however, mRNA content was unaltered in contrast to previous reports of no change in ornithine decarboxylase and thymidine kinase after sham hepatectomy. This may be mediated by the decrease in food intake after hepatectomy. Therefore it is necessary to examine the effect of food intake after hepatectomy on the ODC activity and mRNA level in the future.

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Catechol-O-Methyltransferase Activity from Regenerating Liver after Partial Hepatectomy in Rats

  • Kim You-Hee;Choi Hye-Jung;Kwak Chun-Sik
    • Biomedical Science Letters
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    • v.11 no.1
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    • pp.45-49
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    • 2005
  • The change of catechol-O-methyltransferase (COMT) activity during regeneration of rat liver was studied. Cytosolic, mitochondrial and microsomal COMTs activities were estimated in regenerating rat livers over a period of ten days after $70\%$ (median and left lateral lobes) partial hepatectomy. The values of Km and Vmax in the hepatic enzymes were also measured. The activities of cytosolic and microsomal COMTs in regenerating rat liver after partial hepatectomy were found to be significantly increased between the second and the third day. Whereas the mitochondrial COMT activity did not change. The Vmax values of the cytosolic and microsomal COMTs in the regenerating rat liver were significantly increased at the second day after partial hepatectomy, however, the Km values of the above hepatic enzymes did not vary in all the experimental groups. Therefore, the results suggest that the biosynthesis of COMT was increased during the regeneration of rat liver.

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Influence of Clinically Significant Portal Hypertension on Hepatectomy for Hepatocellular Carcinoma: a Meta-analysis

  • Tang, Yun-Hao;Zhu, Wen-Jiang;Wen, Tian-Fu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1649-1654
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    • 2014
  • Background: Clinically significant portal hypertension (PHT) is considered as a contraindication for hepatectomy according to the guidelines of the European Association for Study of Liver and the American Association for Study of Liver Diseases. However, this issue remains controversial. Here we performed a metaanalysis to evaluate the impact of PHT on the results of hepatectomy for hepatocellular carcinoma (HCC). Methods: Cohort studies evaluating the impact of clinically significant PHT, defined as oesophageal varices and/or splenomegaly associated with thrombocytopenia, on the results of hepatectomy for HCC were identified using a predefined search strategy. Summary risk ratios (RRs) and 95% confidence intervals (95% CIs) for PHT and outcomes after hepatectomy for HCC were calculated. Results: Seven cohort studies which including 574 cases with PHT and 1,354 cases without PHT were considered eligible for inclusion. The meta-analysis showed that, in all patients, pooled RRs of post-operative liver failure, post-operative ascites, peri-operative blood transfusion, operative mortality, 3- and 5-year overall survival associated with PHT were 2.23 (95% CI: 1.48-3.34, P=0.0001), 1.77 (95% CI: 1.19-2.64, P=0.005), 1.23 (95% CI: 1.03-1.49, P=0.03), 2.58 (95% CI: 1.12-5.96, P=0.03), 0.82 (95% CI: 0.75-0.88, P<0.00001) and 0.76 (95% CI: 0.69-0.85, P<0.00001), respectively. In subgroup analysis, similar results were found in Child-Pugh class A patients. Conclusion: This meta-analysis suggests that presence of oesophageal varices and/or splenomegaly associated with thrombocytopenia is associated with higher rates of post-operative complications and poor long-term survival after hepatectomy for HCC.

Observation of Histochemical Ultrastructure in Regenerating Rat Liver (재생중인 흰쥐 간세포의 조직화학적 미세구조 관찰)

  • Choi, Chee-Yong;Sohn, Seong-Hyang;Yoo, Chang-Kyu;Choe, Rim-Soon
    • Applied Microscopy
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    • v.18 no.2
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    • pp.205-217
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    • 1988
  • An ultrastructural study of hepatocyte proliferation in the regenerating rat liver has been made by means of the partial hepatectomy. And electron microscopic histochemistry of hepatocyte in the regenerating rat liver is studied through alkaline phosphatase reaction. The results are as follows: 1. When the regeneration of rat liver is induced by the partial hepatectomy, the prominent ultrastructural characteristics of hepatocyte are changes of the distribution of chromatin in nucleus, increase of the number of mitochondria and decrease of the size of them, development of rough endoplasmic reticulum, and transient decrease of glycogen granules in cytoplasm. 2. Alkaline phosphatase reaction products are appeared in the nucleus or rough endoplasmic reticulum of hepatocyte during the initial regeneration of liver as 24, 48 and 72 hour groups after partial hepatectomy. And these positive reaction are mainly increased in cytoplasm and plasma membrane of hepatocytes during 1, 2 and 3 week groups after partial hepatectomy. As 4 weeks passed after partial hepatectomy, these positive reaction is located in the sinusoidal epithelial cells or erythrocytes. With above results, we concluded that alkaline phosphatase was synthesized in the rough endoplasmic reticulum bounded ribosomes of regenerating hepatocyte, was transported to the plasma membrane of them, and then was transported in blood by the way sinusoidel epithelial cells.

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Partial Hepatectomy in a Canine Hepatocellular Carcinoma (부분 간절제술을 통한 개의 간세포암종 치료예)

  • 이충호;최재훈;정성목;김완희;김대용
    • Journal of Veterinary Clinics
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    • v.18 no.2
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    • pp.170-173
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    • 2001
  • Primary hepatocellular carcinomas are rare in dogs. A 12-year-old 5.4 kg female Poodle was referred to the Veterinary Medical Teaching Hospital with abdominal distension and mild anorexia. In this case, an extensive soft tissue mass was clearly palpable in the upper abdomen and radiography revealed a spherical mass of soft tissue density in the abdomen but its origin was not clear. In following an exploratory laparotomy, a partial hepatectomy was performed. Surgical complications were minimal. The survival time was seven months before dyspnea lead to a sudden and rapid decline.

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Long-term Prognosis in Hepatocellular Carcinoma Patients after Hepatectomy

  • Zhou, Lei;Liu, Chang;Meng, Fan-Di;Qu, Kai;Tian, Feng;Tai, Ming-Hui;Wei, Ji-Chao;Wang, Rui-Tao
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.483-486
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    • 2012
  • Background: The hepatocellular carcinoma is very common in China. Our aim in this report was to investigate clinical and pathological factors based on the current decade data that could influence prognosis of HCC patients after hepatectomy. Methods: Between 2002 and 2009, all patients undergoing hepatectomy for HCC were followed up and reviewed retrospectively. Prognostic factors were studied by univariate and multivariate analysis, with Kaplan-Meier and Cox multivariate survival analyses. Results: Complete clinicopathologic and follow-up data were available for 114 patients. The estimated cumulative survival rates at 1, 3, and 5 yr were 84.6%, 60.2% and 51.8%, respectively. On univariate analysis, key prognostic factors were AFP level, GGT level, tumor size, number of tumors, portal vein invasion, liver cirrhosis status and TNM stage. In the multivariate analysis, tumor size, GGT level, liver cirrhosis status and portal vein invasion were significantly associated with patients' prognosis. Conclusion: Through follow-up of a relatively large cohort of Chinese patients, tumor size, GGT level, liver cirrhosis status, portal vein invasion were revealed as important factors for long-term survival after hepatectomy. Early diagnosis for tumor and the improvement of liver function before surgery are important ways to improve the prognosis.

Impact of a Clinical Pathway on Hospital Costs, Length of Stay and Early Outcomes after Hepatectomy for Hepatocellular Carcinoma

  • Zhu, Liang;Li, Jun;Li, Xiao-Kang;Feng, Jun-Qiang;Gao, Jian-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5389-5393
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    • 2014
  • Background: A clinical pathway (CP) can standardize and improve perioperative care for a number of interventions. In hepatic surgery, however, pertinent evidence is very limited. This study was conducted to implement a CP for hepatocellular carcinoma (HCC) patients undergoing hepatectomy, and to evaluate its effects on hospital costs, length of hospital stay (LOHS) and early clinical outcomes. Materials and Methods: Medical records for HCC patients undergoing hepatectomy were retrospectively reviewed before implementation of a CP (the non-CP group) from March 2012 to August 2012. This information was compared with the data collected prospectively from patients after implementation of the CP (the CP group) between September 2012 and April 2013. Hospital costs, LOHS and early clinical outcomes were evaluated and compared between groups. Results: There were no significant differences in terms of patient clinical characteristics between the two groups. For clinical outcome measures, no significant differences were found in postoperative complications, mortality and readmission rate. The hospital costs were significantly reduced from 24,844 RMB in the non-CP group to 19,761 RMB in the CP group (p<0.01). In addition, patients of the CP group also had shorter LOHS compared with the non-CP group (8.3 versus 12.3 days, p<0.001). Conclusions: The CP proved to be an effective approach to minimize hospital costs and LOHS with hepatectomy for HCC without compromising patient care.

Clinical Study of Hepatectomy Combined with Jianpi Huayu Therapy for Hepatocellular Carcinoma

  • Zhong, Chong;Li, Hui-Dong;Liu, Dong-Yang;Xu, Fa-Bin;Wu, Jian;Lin, Xue-Mei;Guo, Rong-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5951-5957
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    • 2014
  • Background: Traditional Chinese Medicine (TCM) possesses several advantages for treating patients with hepatocellular carcinoma (HCC). The theory of 'Jianpi Huayu Therapy' rooted from 'Jin Kui Yao Lue'is one of the most important therapies in this respect. This study was conducted to investigate the clinical effect and safety of hepatectomy combining with 'Jianpi Huayu Therapy' in the treatment of HCC. Materials and Methods: One hundred and twenty patients with HCC were randomized allocated into hepatectomy combined with 'Jianpi Huayu Therapy' group (treatment group, n=60) and hepatectomy alone group (control group, n=60). Disease- free survival (DFS) and overall survival (OS) were the primary end-points. Liver function at the end of one week after surgery, complications, average days of hospitalization as well as performance status (PS) at the end of one month post operation were also compared. Results: No significant differences existed between two groups on baseline analysis (p>0.05). No treatment related mortality occurred in either group. Post-operative complications were detected among 14 patients (23.3%) in the treatment group, and 12 (20.0%) in the control group (p=0.658). Alanine aminotransferase (ALT) at the end of one week after operation was lower in the treatment than control groups (p=0.042). No significant differences in other indexes of liver function were discovered between two groups. Average days of hospitalization reduced by 0.9 day in treatment group than in control (p=0.034). During follow-up, 104 patients (86.6%) developed recurrence. The rates of 1-, 3-, and 5-year DFS and median DFS for all patients were 77.4%, 26.3%, 9.0% and 25.6 months (range, 6.0~68.0), respectively (78.2%, 29.2%, 14.3% and 28.7 months for the 48 patients in the treatment group and 75.0%, 23.3%, 6.4%, and 22.6 months for the 56 patients in the control group (p=0.045)). 101 patients had died at the time of censor, with 1-, 3-, and 5-year overall survival rates and median survival for all patients of 97.5%, 76.4%, 40.5% and 51.2 months (range, 10.0~72.0), respectively (98.3%, 78.0%, 43.6% and 52.6 months, for treatment and 96.7%, 74.7%, 37.4%, and 49.8 months, for controls, respectively (p=0.048)). Conclusions: Hepatectomy combined with 'Jianpi Huayu therapy'was effective in the treatment of HCC, and reduced post-operative recurrence and metastasis and improved DFS and OS of HCC patients.

Genistein Reinforces the Inhibitory Effect of Cisplatin on Liver Cancer Recurrence and Metastasis after Curative Hepatectomy

  • Chen, Peng;Hu, Ming-Dao;Deng, Xiao-Fan;Li, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.759-764
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    • 2013
  • Background: The high recurrence rate after hepatic resection in hepatocellular carcinoma (HCC) is a major obstacle to improving prognosis. The objective of the present study was to explore the function of genistein, a soy-derived isoflavone, in enhancing the inhibitory effect of cisplatin on HCC cell proliferation and on tumor recurrence and metastasis in nude mice after curative hepatectomy. Methods: Proliferation of human HCC cells (HCCLM3) was detected by 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay. Synergistic effects of genistein and cisplatin were evaluated with the median-effect formula. Nude mice bearing human HCC xenografts underwent tumour resection (hepatectomy) 10 days post implantation, then received intraperitoneal administration of genistein or cisplatin alone or the combination of the two drugs. 33 days after surgery, recurrent tumours and pulmonary metastasis were evaluated individually. MMP-2 level in recurrent tumours was detected by immunohistochemistry and real-time PCR; MMP-2 expression in HCCLM3 was detected by immunocytochemistry. Results: Genistein and cisplatin both suppressed the growth and proliferation of HCCLM3 cells. The two drugs exhibited synergistic effects even at relatively low concentrations. In vivo, mice in the combined genistein and cisplatin group had a smaller volume of liver recurrent tumors and fewer pulmonary metastatic foci compared with single drug treated groups. Cisplatin upregulated the expression of MMP-2 in both recurrent tumours and HCCLM3, while genistein abolished cisplatin-induced MMP-2 expression. Conclusions: Genistein reinforced the inhibitory effect of cisplatin on HCC cell proliferation and tumour recurrence and metastasis after curative hepatectomy in nude mice, possibly through mitigation of cisplatin-induced MMP-2 upregulation.