ObjectiveTo establish a model of portal hypertension with hypersplenism in SD rats by portal vein binding combined with splenic vein ligation. MethodsSixty healthy male SD rats were randomly divided into three groups: sham operation group （only laparotomy, n=20）, portal vein binding group (only binding, n=20), and portal vein binding combined with splenic vein ligation group (combined operation group, n=20). The counts of platelet, erythrocyte, and leukocyte were examined just before operation and once a week after operation for 7 weeks. Portal pressure, shortaxis, and longaxis diameter of spleen were examined just before operation and seven weeks after operation. At the seventh week, all the animals were sacrificed, spleen index and pathology changes of each group were examined. ResultsErythrocyte and platelet counts in combined operation group were significantly lower than those in the other two groups on the third week （Plt;0.05）, and there was no significant difference in leukocyte count among three groups （Pgt;0.05）. Compared with the preoperative value, portal pressure increased significantly on the seventh week in both portal vein binding group and combined operation group, and was higher than that in the sham operation group （Plt;0.05）. The two diameters of spleen also increased significantly in combined operation group on the seventh week （Plt;0.05）, and were larger than those in the other two groups （Plt;0.05）. The same result was found in spleen index （Plt;0.05）. Typical pathological changes of hypersplenism presented only in combined operation group on the seventh week after operation. ConclusionsPortal vein binding combined with splenic vein ligation can induce experimental secondary hypersplenism successfully. This procedure is simple and stable, and helpful to the scientific research.
Objective To explore the differential expressions of seven microRNAs between hepatocellular carcinoma (HCC) and adjacent nontumorous tissues (NT), analyze the correlations between differential expressing microRNAs and the levels of tumor markers in serum, and furnish evidence for novel diagnostic and prognostic tool of HCC. Methods Real-time quantitative PCR technique was used to measure the differential expressions of seven microRNAs in HCC tissues compared with NT. Results Compared with NT, the relative expressions of seven microRNAs in HCC tissues manifested statistical difference (Plt;0.05). MiR-34c, miR-21, miR-16, and miR-10b presented higher expressions in the HCC samples than those in the NT samples, while miR-200a, miR-148b, and miR-Let-7i demonstrated lower expressions in the HCC samples than those in the NT samples. In addition, miR-200a and miR-148b were markedly down-regulated in the HCC tissues than those in the NT. The differential expressions of miR-200a in HCC compared with NT samples was correlated with serum AFP level of the patients (r=0.848 9, Plt;0.01), while the differential expressions of the other six microRNAs had no correlation with the levels of tumor markers in serum (Pgt;0.05). Conclusions There are differential expressions of microRNAs between HCC and NT. MiR-200a may serve as a novel diagnostic and prognostic tool of HCC.
ObjectiveTo investigate feasibility and safety of laparoscopic liver resection with vascular variation.MethodsThe clinical data of one patient with preoperative diagnosis of primary liver cancer, who was admitted into the Department of Hepatobiliary Surgery of the Second Affiliated Hospital of Army Military University in October 2017, were analyzed retrospectively. The three-dimensional (3D) reconstruction was completed basing on the preoperative CT data, then the liver volume was calculated and the preoperative planning was made, finally the subsequent surgery was performed.ResultsThe results of the 3D reconstruction suggested that the tumor was situated in the central of the right liver, including the segment Ⅴ, Ⅵ, Ⅶ, and Ⅷ. There was a type Ⅱ portal vein variation, the right anterior branch of the portal vein divided a branch into the left medial lobe. The right hepatic vein was divided into the ventral and dorsal branches. There was a thick right posterior inferior vein in this case. The preoperative planning was that the right posterior lobectomy or right anterior lobectomy could not completely remove the tumor. According to the standard right hemihepatectomy, the remaining liver volume accounted for 27% of the standard liver volume. If preserving the right anterior branch of the portal vein for the right hemihepatectomy, the remaining liver volume accounted for 41% of the standard liver volume. According to the concept of precise hepatectomy, the laparoscopic partial right hepatectomy with preservation of the main branch of the right anterior portal vein was performed smoothly. The liver function recovered well after the surgery. The right pleural effusion appeared after the surgery, then was relieved by the thoracentesis.ConclusionFor primary liver cancer patient with vascular variation, laparoscopic liver resection is feasible and safe basing on guide of 3D reconstruction technology.
ObjectiveTo investigate the clinical application value of laparoscopic anatomical resection of liver segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein.MethodsClinical data of 8 patients who underwent laparoscopic anatomical resection of liver segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein in Xinqiao Hospital from May 2017 to December 2019 were retrospectively analyzed. The operation time, intraoperative blood loss, postoperative complications, and hospitalization duration were observed.ResultsAll patients were confirmed by pathology, the postoperative pathological results showed that: hepatocellular carcinoma was found in 6 patients, mixed hepatocellular carcinoma and cholangiocarcinoma was found in 2 patients. All patients completed the operation successfully without conversion to open surgery. The median operation time was 220 min (190-240 min), median blood loss was 230 mL (200-280 mL), and blood transfusion was not needed. The postoperative median hospital stay was 8 d (7–12 d). All the patients recovered well without severe complications. Eight patients were followed up for 10.5 to 31.7 months, with a median follow-up time of 16.9 months. During the follow-up period, none of them developed hemorrhage, bile leakage, and other complications. There was no reoperation or perioperative mortality during the follow-up.ConclusionsThe method of laparoscopic anatomical resection of liver segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein is safe and effective. This method can shorten the operation time, improve the safety, and reduce the difficulty of operation.