COMPARISON OF CONTINUOUS VERSUS INTERMITTENT ISCHEMIA-REPERFUSION DURING LIVER RESECTION IN AN EXPERIMENTAL-MODEL

It has been proposed that regular restoration of blood how is benefici al during liver surgery with vascular isolation. The aim of this study was to compare intermittent versus continuous occlusion of blood flow to the resected liver, as measured by survival, liver function tests and histological examination. Male Wistar rats were allocated to have either sham operation, 80 per cent liver resection with 30 min continu ous occlusion, or resection with intermittent occlusion (two 15-min pe riods of ischaemia separated by 5 min reperfusion). There was no signi ficant difference in the survival rate, with 17 of 20 animals survivin g in both ischaemia groups. There was a significantly higher serum ala nine aminotransferase concentration on day 1 in animals receiving cont inuous occlusion, and significantly bilirubin on days 8 and 23 phospha tase on day 23 in those having intermittent ischaemia (P < 0.001). The re was a significantly greater loss and slower regaining of weight whe n occlusion was intermittent. Histological changes were significantly more pronounced at day 23 in animals undergoing intermittent ischaemia (P < 0.05), although these were in only one grading. Continuous and i ntermittent occlusion affected the components of liver function tests differently, with no advantage for one technique. These findings sugge st that periodic release of inflow occlusion during liver surgery is n ot necessary.