Hepatic cell proliferation peaks one week after portal vein ligation and is not enhanced by insulin (experimental study)

Introduction: Selective portal vein ligation is currently used to induce hypertrophy of healthy liver segments before partial hepatectomy performed to treat metastatic or primary liver cancer. A major limitation of this procedure is the time interval needed between the portal ligation and hepatic resection, potentially leading to tumour progression. We report the characterization of the liver regeneration kinetics after portal ligation on a rat model, also testing the usefulness of insulin to accelerate liver hypertrophy after the procedure. Materials and Methods: Liver function and morphology in male Wistar rats was evaluated 1, 2 or 4 weeks after portal ligation alone or with concomitant continuous intraperitoneal insulin infusion and compared to those of intact controls. Results: Selective portal vein ligation induced ipsilateral lobe atrophy and contralateral lobe hypertrophy. In this model, liver lobe hypertrophy reached its peak at 1 week after portal ligation (PVL:0,13cm; PVL+Insulin:0,34cm) and insulin infusion had no significant additional effect on the liver response to portal ligation. Discussion and conclusion: Hepatocyte proliferation after selective portal ligation was a fast phenomenon, peaking as early as 1 week after the procedure. Insulin was not useful as adjuvant therapy to further increase hepatocyte proliferation after portal ligation in the rat.