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World Journal of Surgery

Erschienen in:

01.02.2007

Mechanisms of Hepatic Regeneration Following Portal Vein Embolization and Partial Hepatectomy: A Review

verfasst von: Y. Yokoyama, M. Nagino, Y. Nimura

Erschienen in: World Journal of Surgery | Ausgabe 2/2007

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Abstract

Background

Portal vein embolization (PVE) improves outcome following major hepatectomy, and basic studies have presented evidence related to the mechanisms responsible for hepatic regeneration. Hemodynamic changes following PVE are similar to, but slightly different from, those of partial hepatectomy (PH) because arterial flow to the embolized lobe is preserved. However, the process of hepatic regeneration is essentially the same after both PVE and PH. A number of mediators are involved in PVE or PH-induced hepatic regeneration. These include inflammatory cytokines, vasoregulators, growth factors, eicosanoids, and various hormones. These mediators activate a complex network of signal transduction that promotes hepatic regeneration. A variety of conditions have been shown to modulate the function of these mediators and inhibit regeneration. These include biliary obstruction, diabetes, chronic ethanol consumption, malnutrition, gender, aging, and infection.

Conclusion

Optimizing these factors, where possible, before PVE or PH, is essential to maximize hypertrophy of the liver. A fuller understanding of hepatic physiology and pathophysiology following PVE or PH may lead to greater functional capacity of the remaining liver and extend the indications for hepatectomy in patients who require large liver volume resection.

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Titel: Mechanisms of Hepatic Regeneration Following Portal Vein Embolization and Partial Hepatectomy: A Review
verfasst von: Y. Yokoyama
M. Nagino
Y. Nimura
Publikationsdatum: 01.02.2007
Verlag: Springer-Verlag
Erschienen in: World Journal of Surgery / Ausgabe 2/2007
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-006-0526-2

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Mechanisms of Hepatic Regeneration Following Portal Vein Embolization and Partial Hepatectomy: A Review

Abstract

Background

Conclusion

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