Effect of portal hypertension on bacterial translocation induced by major liver resection in rats.

OBJECTIVE

To evaluate the influence of portal hypertension on bacterial translocation from the gut caused by major hepatic resection.

DESIGN

Randomised study.

SETTING

University of Lund, Sweden.

MATERIAL: 228 adult male Sprague-Dawley rats.

INTERVENTIONS: Laparotomy and separation of the liver from its attachments (sham operated group), 70% hepatic resection, 90% hepatic resection, or subtotal ligation of the portal vein. For assessment of the degree of bacterial translocation a further laparotomy was done, 0.2 ml of blood taken from the portal vein and 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 flowmetry with the probe held gently against the bowel wall at six points randomly chosen from the distal small intestine and colon.

MAIN OUTCOME MEASURES: Alterations in portal venous pressure, arterial pressure, and bacterial translocation to other organs, particularly mesenteric lymph nodes.

RESULTS

Bacterial translocation increased significantly after 90% hepatectomy, and there was an increase in portal pressure together with a decrease in systemic arterial pressure after both 90% hepatectomy and subtotal ligation of the portal vein. Subserosal blood flow to the distal small intestine decreased after 70% resection, 90% resection, and subtotal ligation of the portal vein; subserosal blood flow to the colon decreased only after 90% hepatectomy.

CONCLUSION

Increased portal venous pressure after major hepatic resection is not the sole cause of the increase in the incidence of bacterial translocation from the gut in rats.