Primary animal experiment to test the feasibility of a novel Y-Z magnetic hepatic portal blocking band

BACKGROUND Hepatic portal blood flow occlusion is a common technique for reducing hepatic hemorrhage during hepatectomy.We designed a novel Y-Z magnetic hepatic portal blocking band(Y-Z MHPBB)based on the principle of magnetic compression technique.AIM To introduce the Y-Z MHPBB device and verify the feasibility of this device for hepatic portal blood flow occlusion in dogs.METHODS Ten beagles were randomly divided into the experimental group and control group.The operation time,intraoperative blood loss,the number of portal blood flow occlusions,the total time spent on adjusting the blocking band,and the average time spent on adjusting the blocking band were recorded.The surgeons evaluated the feasibility and flexibility of the two portal occlusion devices.RESULTS Laparoscopic hepatectomy was successfully performed in both the experimental group and control group.There was no statistical difference between the two groups in the operation time,intraoperative blood loss,and the number of hepatic portal blood flow occlusions.With respect to the total time spent on adjusting the blocking band and the average time spent on adjusting the blocking band,the experimental group showed significantly better outcomes than the control group,with a statistical difference(P<0.05).The operators found that the Y-Z MHPBB was superior to the modified T-tube in terms of operational flexibility.CONCLUSION The Y-Z MHPBB seems to be an ingenious design,accurate blood flow occlusion effect,and good flexibility;and it can be used for hepatic portal blood flow occlusion during laparoscopic hepatectomy.

Altered expression in liver cancer with various hepatic blood flow occlusions: A pilot RNA sequencing study

Background and aims:Hepatocellular carcinoma is one of the most common cancers worldwide.Previous studies have reported he influence of various hepatic blood flow occlusions on tumor behavior,which is mainly mediated by liver ischemia-reperfusion.Although some genes and pathways have been determined,the whole transcriptome after various hepatic blood flow occlusions is lacking.Methods:We systematically explored transcriptome changes after various hepatic blood flow occlusions,including sham operation(SO;n=10),occlusion of the portal triad(OPT;n=10),and occlusion of the portal vein(OPV;n=10),by RNA-sequencing.Results:HE sections and TUNEL assays showed different liver injury among groups.We identified the top altered genes and pathways.Compared with the SO group,96 genes were altered in OPV,with 81 upregulated and 15 downregulated genes.The top 5 upregulated genes were Pdk4,Serpina12,Depp1,Igfbp1,and Mup22.The top 5 downregulated genes were Sprr1a,Serpinb2,Tnc,Cdkn3,and Cenpu.Compared with the SO group,there were 20 differentially expressed genes in OPT,with 18 upregulated and 2 downregulated genes.The top 5 upregulated genes wereC7,Zbtb16,Gabrp,Pdk4,and Mmrn1.The top 2 downregulated genes were Krt20 and Sis.Compared with the OPV group,72 differentially expressed genes were in OPT,with 39 upregulated and 33 downregulated genes.The top 5 upregulated genes wereHspa1b,Hbb-bs,Phf19,Ddias,and Rad54b.The top 5 downregulated genes were Cish,Socs2,Slc25a30,Rgs3,and Hsd3b5.Conclusion:Various surgical methods have an obvious influence on the transcriptome of tumors.

Hepatic blood inflow occlusion with/without hemihepatic artery control versus the Pringle maneuver in resection of hepatocellular carcinoma： a retrospective comparative analysis

Background The Pringle maneuver, which has been the standard for hepatic resection surgery for a long time, has the major flaw of ischemic damage in the liver. The aim of this research was to evaluate hepatic blood inflow occlusion with/without hemihepatic artery control vs. the Pringle maneuver in hepatocellular carcinoma （HCC） resection. Methods Two hundred and eighty-one cases of resection of HCC with hepatic blood inflow occlusion （with/without hemihepatic artery control） and the Pringle maneuver from January 2006 to December 2008 in our hospital were analyzed and compared retrospectively; among them 107 were in group I （Pringle maneuver）, 98 in group II （hepatic blood inflow occlusion）, and 76 in group III （hepatic blood inflow occlusion without hemihepatic artery control）. The operation time, intraoperative blood loss, postoperative liver function and complications were used as the endpoints for evaluation. Results The operative duration and intraoperative blood loss of three groups showed no significant difference; alanine aminotransferase, total bilirubin and incidence of postoperative complications were significantly lower in groups II and Ill postoperation than those in group I. Conclusion Hepatic blood inflow occlusion without hemihepatic artery control is safe, convenient and feasible for resection of HCC, especially for cases involving underlying diseases such as cirrhosis.