EFFECT OF PORTAL-HYPERTENSION ON BACTERIAL TRANSLOCATION INDUCED BY MAJOR LIVER RESECTION IN RATS

Objective: To evaluate the influence of portal hypertension on bacteri al translocation from the gut caused by major hepatic resection. Desig n: Randomised study. Setting: University of Lund, Sweden. Material: 22 8 adult male Sprague-Dawley rats. Interventions: Laparotomy and separa tion of the liver from its attachments (sham operated group), 70% hepa tic resection, 90% hepatic resection, or subtotal ligation of the port al vein. For assessment of the degree of bacterial translocation a fur ther laparotomy was done, 0.2 ml of blood taken from the portal vein a nd the vena cava, and specimens taken of mesenteric lymph nodes, liver , spleen, lungs, proximal jejunum, distal ileum, and transverse colon. Microcirculation of the intestine was measured by laser Doppler flowm etry with the probe held gently against the bowel wall at six points r andomly chosen from the distal small intestine and colon. Main outcome measures: Alterations in portal venous pressure, arterial pressure, a nd bacterial translocation to other organs, particularly mesenteric ly mph nodes. Results: Bacterial translocation increased significantly af ter 90% hepatectomy, and there was an increase in portal pressure toge ther with a decrease in systemic arterial pressure after both 90% hepa tectomy and subtotal ligation of the portal vein. Subserosal blood flo w to the distal small intestine decreased after 70% resection, 90% res ection, and subtotal ligation of the portal vein; subserosal blood flo w to the colon decreased only after 90% hepatectomy. Conclusion: Incre ased portal venous pressure after major hepatic resection is not the s ole cause of the increase in the incidence of bacterial translocation from the gut in rats.