Metabolic and Steatohepatitis
The impact of hepatic steatosis on liver regeneration after partial hepatectomy
Version of Record online: 14 JAN 2013
© 2012 John Wiley & Sons A/S
Volume 33, Issue 3, pages 469–475, March 2013
How to Cite
Liver Int 2013; 33: 469–475.
- Issue online: 12 FEB 2013
- Version of Record online: 14 JAN 2013
- Accepted manuscript online: 12 DEC 2012 06:03AM EST
- Manuscript Accepted: 1 DEC 2012
- Manuscript Received: 23 JUL 2012
- hepatic steatosis;
- liver regeneration;
- partial hepatectomy
Background & Aim
Experimental studies in animals have suggested that liver regeneration is impaired in steatotic livers. However, few studies have focused on the impact of steatosis in patients undergoing partial hepatectomy (PH). This study aims to determine the role of steatosis on liver regeneration in humans following PH.
Eighty-eight patients undergoing PH were included in this study. All patients underwent CT-scanning of the liver preoperatively and 7 days after surgery. Additional CT-scans were performed 6 months post-operatively. Preoperative and post-operative volumes of the total liver (TLV), future liver remnant (FLR) and liver remnant (LR) were measured on CT-scans. Regeneration indices (RI) were calculated at 7 days and 6 months using the formula: (Volume LR−Volume FLR)/Volume FLR × 100%. Based on histological examination of the resected part of the liver, patients were classified into three groups: (1) no steatosis, (2) mild steatosis (1–29%) and (3) moderate-to-severe steatosis (≥30%).
The early RI (at day 7) was 40%, 24% and 20% for patients in group 1, 2 and 3 respectively. Late RI (at 6 months) was 81% for group 1, 44% for group 2 and 22% for group 3 (P = 0.019). At 7 days, the LR represented 79%, 80% and 79% of the TLV for groups 1–3. At 6 months, this was 93%, 92% and 79% respectively.
Although early RI after PH did not differ in patients with or without steatosis, the late RI in patients with moderate-to-severe steatosis was lower, suggesting that late liver regeneration is impaired in these patients.