Abstract
The expression of vascular adhesion molecules and neutrophil adherence were investigated in the liver to evaluate the adverse effects of a temporary interruption of the hepatic inflow (Pringle's maneuver) during hepatectomy. In liver tissue specimens obtained from 16 patients (10 with liver cirrhosis (LC) and 6 without LC), immunohistochemical staining was used to detect the expression of granular membrane protein-140 (GMP-140), endothelial leukocyte adhesion molecule-1 (ELAM-1), and vascular cell adhesion molecule-1 (VCAM-1) by the hepatic vascular endothelium. In addition, neutrophil elastase was immunostained. After hepatectomy, the expressions of GMP-140 and VACM-1 were significantly higher in patients with LC than in those without LC. There was weak expression of ELAM-1 in the cirrhotic liver which was observed in 2 cases, but no expression in the non-cirrhotic liver. The adherent neutrohil count in liver tissue after hepatectomy was significantly higher in LC patients than that before hepatectomy as well as than that of non-LC patients.
In conclusion, Pringle's maneuver enhances the hepatic neutrophil adhesion by upregulating the expression of endothelial adhesion molecules during an early period after hepatectomy, which may cause damage to the remnant liver in LC patients.
