HEPATIC REGENERATION FOLLOWING RIGHT LOBECTOMY - ESTIMATION OF REGENERATIVE CAPACITY

The regenerative capacity of the liver was assessed using a volumetric method on computed tomography in 21 adults: 16 underwent a standard r ight hepatic lobectomy for hepatocellular carcinoma, there were hepati c metastases in 3 others, and 2 suffered from other diseases. The pati ents' ages ranged from 33 to 68 years with a mean age of 57.0 years. T he regeneration rate was expressed as the rate of the volume increase of the remnant left lobe compared with the preoperative volume of the left lobe. A univariate regression analysis showed that the portal pre ssure had a highly inverse correlation with the regeneration rate of t he liver (r = -0.4753, P = 0.0397), while a multiple regression analys is demonstrated the correlation between the portal pressure, age, and the regeneration rate (multiple r = 0.5640). The regeneration rate of the normal liver (97.6 +/- 53.5%) was significantly higher than that o f the chronic hepatitic (43.0 +/- 40.7%), and also tended to be higher than that of the cirrhotic liver (51.5 +/- 13.2%). However, there wer e no differences between chronic hepatitic and cirrhotic livers. The p ortal pressure before hepatectomy of the normal liver (149 +/- 19 mmH2 O) was significantly lower than those of chronic hepatitic (188 +/- 38 mmH2O) and cirrhotic (245 +/- 78 mmH2O) livers. We thus conclude that the regenerative capacity of the liver following a right hepatic lobe ctomy could be estimated on the basis of both portal pressure and age. The regenerative capacity was also influenced by underlying liver dis eases.