![]() As early as a century ago, experiments in rabbits showed that selective occlusion of a large branch of the portal vein causes atrophy of the ipsilateral lobe and hypertrophy of the contralateral liver lobe. 1, 2 Owing to the unique and versatile ability of the liver to regenerate, a number of strategies have been developed to increase the volume of a potential future remnant liver. 1 One limiting factor for success is the size and function of the remnant liver left after surgery. Liver resection is the only chance of cure in many patients with primary or secondary liver tumors. Lower blood flow and lower accumulation of macrophages, particularly Kupffer cells, in the regenerating part of the liver likewise causes impaired liver regeneration after PVE. The impairment of liver regeneration after PVE may be a consequence of macrophage trapping in the occluded segment due to a foreign body reaction. Conclusion: PVL is superior to PVE in inducing a regenerative response of the remnant liver. The embolized part of the liver after PVE showed prominent foreign body reaction in the portal triad with accumulation of macrophages. Transcript levels of cytokines (interleukin-1β, tumor necrosis factor-α, interleukin-6) peaked at 24 hours and were highest after PH. The accumulation of Kupffer cells 24 hours after the intervention was highest after PH. Volumetric blood flow and functional sinusoidal density were lower after PVE than after PVL ( P = 0.006, P = 0.02, respectively). In Ki-67 and PCNA stainings, hepatocyte proliferation after PVL was more pronounced than after PVE ( P = 0.01). ![]() The weight of the regenerating liver segments increased continuously in all groups, with the highest weight gain after PH, which also disclosed the strongest proliferative activity. Sinusoidal perfusion was examined by intravital microscopy. Liver weight and markers of regeneration were assessed at 24, 48, and 72 hours, and 7 days after surgery (n = 5). PVL and PVE of liver segments were validated by portography and histology, demonstrating obstruction of the involved portal branches. Rats were subjected to 70% PVL, 70% PVE, 70% partial hepatectomy (PH) (positive control), or sham operation (negative control). The aim of this study was to compare the impact of PVE and PVL on liver regeneration. ![]() Two strategies are clinically available to induce selective hypertrophy of the liver: portal vein embolization (PVE) and portal vein ligation (PVL).
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