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Effect of an Airbag-selective Portal Vein Blood Arrester on the Liver after Hepatectomy:A New Technique for Selective Clamping of the Portal Vein

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Current Medical Science 2024年第2期44卷 380-390页

作者： Ce-xiong FU Xiao-ri QIN Jin-song CHEN Jie ZHONG Yu-xu XIE Bi-dan LI Qing-qing FU Fang LI Jin-fang ZHENG Department of Hepatobiliary and Pancreatic Surgery Hainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikou 57031lChina University of South China Hengyang 421001China Department of Gastroenterology Gastroenterology Endoscopy CenterHainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikou 57031lChina Center of Clinical Laboratory Hainan General HospitalHainan Afiliated Hospital of Hainan Medical UniversityHaikou 570311China Department of Radiology Hainan General HospitalHainan Afiliated Hospital of Hainan Medical UniversityHaikou 570311China

Objective:A novel technique was explored using an airbag-selective portal vein blood arrester that circumvents the need for an intraoperative assessment of anatomical variations in patients with complex intrahepatic space-occupying lesions.Methods:Rabbits undergoing hepatectomy were randomly assigned to 4 groups:intermittent portal triad clamping(PTC),intermittent portal vein clamping(PVC),intermittent portal vein blocker with an airbag-selective portal vein blood arrester(APC),and without portal blood occlusion(control).hepatic ischemia and reperfusion injury were assessed by measuring the 7-day survival rate,blood loss,liver function,hepatic pathology,hepatic inflammatory cytokine infiltration,hepatic malondialdehyde levels,and proliferating cell nuclear antigen levels.Results:Liver damage was substantially reduced in the APC and PVC groups.The APC animals exhibited transaminase levels similar to or less oxidative stress damage and inflammatory hepatocellular injury compared to those exhibited by the PVC animals.Bleeding was significantly higher in the control group than in the other groups.The APC group had less bleeding than the PVC group because of the avoidance of portal vein skeletonization during hepatectomy.Thus,more operative time was saved in the APC group than in the PVC group.Moreover,the total 7-day survival rate in the APC group was higher than that in the PTC group.Conclusion:Airbag-selective portal vein blood arresters may help protect against hepatic ischemia and reperfusion injury in rabbits undergoing partial hepatectomy.This technique may also help prevent liver damage in patients requiring hepatectomy.

关键词： hepatectomy portal vein hepatic damage selective clamping

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Imaging of the chemotherapy-induced hepatic damage:Yellow liver,blue liver,and pseudocirrhosis

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World Journal of Gastroenterology 2021年第46期27卷 7866-7893页

作者： Linda Calistri Vieri Rastrelli Cosimo Nardi Davide Maraghelli Sofia Vidali Michele Pietragalla Stefano Colagrande Department of Experimental and Clinical Biomedical Sciences Mario Serio University of FlorenceAzienda Ospedaliera Universitaria CareggiFlorence 50134Italy

The liver is the major drug-metabolizing and drug-detoxifying organ.Many drugs can cause liver damage through various mechanisms;however,the liver response to injury includes a relatively narrow spectrum of alterations that,regardless of the cause,are represented by phlogosis,oxidative stress and necrosis.The combination of these alterations mainly results in three radiological findings:vascular alterations,structural changes and metabolic function reduction.Chemotherapy has changed in recent decades in terms of the drugs,protocols and duration,allowing patients a longer life expectancy.As a consequence,we are currently observing an increase in chemotherapy-associated liver injury patterns once considered unusual.Recognizing this form of damage in an early stage is crucial for reconsidering the therapy regimen and thus avoiding severe complications.In this frontier article,we analyze the role of imaging in detecting some of these pathological patterns,such as pseudocirrhosis,“yellow liver”due to chemotherapy-associated steatosis-steatohepatitis,and“blue liver”,including sinusoidal obstruction syndrome,veno-occlusive disease and peliosis.

关键词： hepatic damage Yellow liver Chemotherapy-associated steatohepatitis Blue liver Sinusoidal obstruction syndrome Veno-occlusive disease Peliosis Pseudocirrhosis

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Implications of metabolic dysfunction associated fatty liver disease in COVID-19

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World Journal of Clinical Cases 2023年第6期11卷 1275-1286页

作者： Raja Chakraborty Deepak Sharma Devesh U Kapoor Akanksha Dwivedi Rakhi Khabiya Saikat Sen Institute of Pharmacy Assam Don Bosco UniversityGuwahati 782402AssamIndia School of Medical Sciences Adamas UniversityKolkata 700126West BengalIndia Department of Pharmacy Dr.Dayaram Patel Pharmacy CollegeBardoli 394601GujaratIndia Department of Pharmacy Acropolis Institute of Pharmaceutical Education&ResearchIndore 453771Madhya PradeshIndia Faculty of Pharmaceutical Science Assam down town UniversityGuwahati 781026AssamIndia

Metabolic associated fatty liver disorder(MAFLD)characterizes the contributing etiologies(i.e.,type 2 diabetes mellitus,metabolic syndrome,overweight)of individuals with fatty liver disease that affects 1/3rd of the world population.In 2020,the coronavirus disease 2019(COVID-19)crisis was unprecedented,and people with different comorbidities became more susceptible to the infection caused by severe acute respiratory syndrome coronavirus 2.MAFLD patients are frequently obese with added metabolic menace like diabetes,hypertension,and dyslipidemia leading to greater jeopardy of COVID-19.MAFLD patients are 4 to 6-fold more prone towards infections.COVID-19 induces liver injury with elevated levels of aspartate aminotransferase and alanine aminotransferase and insignificantly elevated bilirubin.Hence,MAFLD in COVID-19 patients worsens the condition significantly.The evidence highlighting the interaction between MAFLD and altered liver functioning in COVID-19 suggested that COVID-19 patients with pre-existing MAFLD are at greater risk of morbidity or intensive care unit admission.Direct hepatic injury,enhanced levels of inflammatory cytokines,declined hepatic mitochondrial activity,and compromised immunity are considered as some underlying mechanisms.The main focus of this review is to discuss the implications of metabolic dysfunction associated with fatty liver disease in COVID-19 patients.The review systematically analyzes the effect of striking two worldwide pandemics(MAFLD and COVID-19)together in the present era.

关键词： Metabolic associated fatty liver disorder COVID-19 Metabolic dysfunction hepatic damage Cytokine storm

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