Microcirculation changes during liver resection--a clinical study.

BACKGROUND: In this study we aimed to evaluate effects of liver resection on hepatic microcirculation. In addition we wanted to study if histological liver damage could be detected intra-operatively. PATIENTS AND METHODS: 40 patients undergoing hepatic resection were included and grouped according to if they were operated with a major or minor resection. Hepatic microcirculation measurements were made intra-operatively before and after liver resection with sidestream dark-field (SDF) imaging. Red blood cell velocity (RBCV), sinusoidal diameter and functional sinusoidal density were determined. RESULTS: After hepatic resection RBCV increased in both the minor and major groups (44 µm/s, P=0.016 and 121 µm/s, P=0.002). RBCV in patients with histological damages was 225 (148-464) µm/s vs. 161 (118-329) µm/s in patients with no damage (P=0.016). CONCLUSION: A hepatic resection leads to an increase of sinusoidal RBCV. SDF imaging could potentially be used to intraoperatively identify histological damages.