WB 02. The Effect of Nitric Oxide Synthase Inhibitor(L-Name) on Ischemia-Reperfusion Injury Following Pringle Maneuver of Cirrhotic Liver Induced by Bile Duct Ligation

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J. Iwasaki, M. Afify, S. Uemoto, R. Tolba

Chair(s): Mustafa Cikirikcioglu, Frank Dor, Attila Szijarto, David J. Hackam, Cliff Shearman, Modise Koto, Yuzo Yamamoto

9:28 - 9:42h at Erszebet Room (A)

Categories: Walter Brendel Award, Hepatobiliary and Pancreatic Surgery

Session: Walter Brendel Award

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Background
Pringle maneuver(PM) has been used widely to control blood loss during liver resection. However, hepatic inflow occlusion can also result in hepatic ischemia–reperfusion injury (IRI), especially in patients with a cirrhotic liver. Nitric oxide(NO) is generated from NO synthase(NOS), and has not only cytoprotective but also cytotoxic effect. The aim of this study was to investigate the effect of the NOS inhibitor(L-NAME) on IRI after PM of cirrhotic livers induced by bile duct ligation(BDL).

Material and Methods
Male Wistar rats were divided into three groups: sham group(non-BDL/no treatment), L-NAME group(BDL with L-NAME treatment) and BDL group(BDL/no treatment). Cirrhosis was induced by BDL. Two weeks after BDL, 50 % partial hepatectomy with PM was performed. The rats of L-NAME group were injected with L-NAME(1.5 mg/kg) 15 minutes before PM. We evaluated the hepatocellular damage, portal venous flow and microcirculation of the liver after reperfusion.

Result
Although there was no significant difference in portal venous flow between L-NAME and BDL group, microcirculation of the liver in LNAME group tended to be higher than that of BDL group(Table). Histopathologically, the semiquantitative score for liver damage and apoptotic index were significantly lower in L-NAME group than in BDL group 168 hrs after reperfusion. Ki-67 labeling index of LNAME group was significantly higher than that of BDL group 24 hrs after reperfusion.

Conclusion
L-NAME attenuated IRI induced by Pringle maneuver, and improved microcirculation of cirrhotic livers.