Metabolic Function and Regeneration of Cirrhotic and Non-cirrhotic Livers after Hepatic Lobectomy in Man

Abstract

Liverfunction in primary liver cell carcinoma (hepatoma) with or without concomitant cirrhosis was evaluated. Metabolic sequelae of hepatic lobectomy in cirrhotic and non-cirrhotic livers were compared. In non-cirrhotic patients, deranged metabolic function was restored to preoperative levels in 3 weeks and to normal in later stages. In cirrhotic patients, some restoration to preoperative levels occurred in the first 3 weeks but without further improvement to normal. Non-cirrhotic liver remnants increased in size in periodic fashion 3 weeks after hepatic lobectomy. No such regenerative power was evident in cirrhotic liver remnants observed up to 1 year and 2 months after hepatic lobectomy. Immediate restoration of impaired function might be due to metabolic reserve in the liver remnant which has been inhibited temporarily by operative trauma. Regenerated liver seemed to be responsible for subsequent restoration of metabolic function in non-cirrhotic patients. In cirrhotic patients surviving hepatic lobectomy, function was not improved over preoperative levels as there was no regeneration of the cirrhotic liver remnant.