FREE-RADICAL OXIDATION AS A PATHOGENETIC FACTOR OF STOMACH AND DUODENAL INJURY IN EARLY POSTOPERATIVE PERIOD AFTER MAXIMALLY PERMISSIBLE LIVER RESECTION

Aim. Assessment of stomach and duodenal injury early after extended hemihepatectomy. Material and Methods. The experiment was performed on 100 white mongrel male rats. 80 of them underwent advanced hemihepatectomy, 20 animals consisted of control group. After 12 hours, 1, 3 and 7 days after surgery stomach and duodenum were histologically analyzed to detect chemiluminescent homogenates. Results. After 12 hours light sum and “fast” flash in the stomach were increased by 2.5 and 1.5 times, respectively, “slow” flash was decreased by 2 times. Growth of all parameters was observed in duodenum. There were significant decrease of “fast” flash and increase of light sum and “slow” flash in homogenates during 3 postoperative days. By the 7th day light sum was increased in stomach and duodenum, besides the duodenum increased “slow” flash. Structural changes were visualized after 12 hours in the form of erosions and ulcers of the stomach and duodenum. In 7 days reparative changes were predominant. Conclusion. In 12 hours after hemihepatectomy rapid activation of free-radical oxidation was observed in stomach and duodenum. Herewith inhibition of antioxidant enzymes have been already showed in stomach. Structural changes in the stomach (ulcers) have already been irreversible by this time. So, this period is critical for acute stomach and duodenal injury.

liver, duodenum, hemihepatectomy, resection, free radical oxidation, injury, ulcer

1. Vishnevsky V.A., Kubyshkin V.A., Chzhao A.V., Ikramov R.Z. Operacii na pecheni [Liver surgery]. Moscow: Miklosh, 2003. 156 p. (In Russian)

2. Hardy J. Liver surgery: the past 2000 years. Aust. N. Z. J. Surg. 1990; 60 (10): 811–817.

3. Que F.G., Nagomey D.M. Resection of “recurrent” colorectal metasteses to the liver. Brit. J. Surg. 1994; 81 (2): 255–258.

4. Vetshev P.S., Musayev G.Kh. Echinococcosis: modern look at the state of the problem. Annaly khirurgicheskoy gepatologii. 2006; 11 (1): 111–117. (In Russian)

5. Wendel W. Beitrage zur Chiryrgie der Leber. Arch. Clin. Chir. 1911; 95: 887.

6. Welch C.S. A Note on transplantation of the whole liver in dogs. Transplant. Bull. 1955; 2: 54.

7. Chardarov N.K., Bagmet N.N., Polishchuk L.O., Shatveryan G.A., Skipenko O.G. Risk factors for biliary complications after liver resection. Annaly khirurgicheskoy gepatologii. 2010; 15 (3): 76–83. (In Russian)

8. Bilenko M.V. Ishemicheskoe i reperfusionnoe povrejdenie organov (molekulyarnye mehanizmy, puti preduprejdeniya i lechenia) [Ischemic and reperfusion damage of organs (molecular mechanisms, prevention and treatment)]. Moscow: Medicine, 1989. 368 p. (In Russian)

9. Yang J.C., Wang Z.W., Li C.L., Lin J.H., Liu X.J., Ji Q.X. Multiple organ injury at early stage of intestinal and hepatic ischemia-reperfusion in rats. Di. Yi. Jun. Xue. Xue. Bac. 2004; 24 (2): 198–200.

10. Sato T., Yasui A., Kondo S., Kato M., Kameoka N., Nimura Y. Changes in liver blood flow after hepatectomy in conscious dogs. Surg. Today. 1996; 26 (9): 688–693.

11. Kahn D., van Hoorn-Hickman R., Terblanche J. Liver blood flow after partial hepatectomy the pig. J. Res. 1984; 37 (4): 290–294.

12. Kurbonov Kh.Kh., Starkov Yu.G. Bleeding from the upper gastrointestinal tract after hepatopancreatobiliary surgery. Khirurgiya. 2007; 10: 73–77. (In Russian)

13. Khokholya V.P., Tarasov A.A., Kononenko I.N. About the risk factors of acute erosions and ulcers of the digestive system in surgical patients. Klinicheskaya khirurgiya. 1987; 8: 29–32. (In Russian)

14. Barskaya L.O., Khramykh T.P., Poluektov V.L., Zavodilenko K.V., Podoynikov M.V., Mikheenko I.L., Poluectov V.V. Some pathogenetic factors of acute gastric damage after extended hemihepatectomy. Sibirskiy medicinskiy jurnal. 2012; 8: 54–57. (In Russian)

15. Khramykh T.P., Dolgikh V.T. By the issue of endotoxemia in hemorrhagic hypotension. Patologicheskaya fiziologiya i experimen talnaya terapiya. 2009; 1: 28–30. (In Russian)

16. Takasu A., Pruedcher S., Tisherman S.A., Stezoski S.W., Stezoski J., Safar P. Effects of increased oxygen breathing in a volume controlled hemorrhagic shock outcome model in rats. Resuscitation. 2000; 45 (3): 209–220.

17. Dolgikh V.T., Razgonov F.I., Shikunova L.G. Lipid peroxidation activation in acute fatal blood loss and cardiac injury. Obshyaya reanimatologiya. 2006; 5–6: 50–54. (In Russian)

18. Dzhurko B.I., Krylov M.I. About the relation of various circulatory system adaptations to hypovolemia in ontogenesis. Patologicheskaya fiziologiya i experimentalnaya terapiya. 2000; 1: 13–15. (In Russian)

19. Mejdunarodnye rekomendacii po provedeniyu medicobiologicheskih issledovaniy s ispolzovaniem jivotnyh. Osnovnye principy [The international recommendations for biomedical researches using animals. Basic principles]. Lanimalogiya. 1993; 1: 29. (In Russian)

20. López-Jiménez F., Paniagua D., Lamas G.A. 1998. La interpretación de los ensayos clínicos negatives. Revista de Investigacion Clinica. 1998; 50 (5): 435–440.

21. Farkhutdinov R.R. Hemilyuminescentnye metody issledovaniya svobodnoradikalnogo okisleniya v biologii i medicine [Chemiluminescent methods for studying of free-radical oxidation in biology and medicine]. Ufa, 1998. 90 p. (In Russian)

22. Starzl T.E., Marchioro T.L., Von Kaulla K.N., Hermann G., Brittan R.S., Waddell W.R. Homotransplantation of the liver in humans. Surgery, Gynecology, and Obstetrics. 1963; 117: 659–676.

23. Hanna S.S., Pagliarello G., Ing A. Liver blood flow after major hepatic resection. Canadian J. Surg. 1988; 31 (5): 363–367.

24. Baue A.E. Multpile organ failure – the discrepancy between our scientific knowledge and understanding and the management our patients. Arch. Surg. 2000; 385 (7): 441–453.

25. Baue A.E. Multiple organ failure, multiple organ dysfunction syndrome, and systemic inflammatory response syndrome. Why no magic bullet? Arch. Surg. 1997; 132 (7): 703–707.

26. Grotz M.R., Deitch E.A., Ding J., Xu D., Huard Q., Regel G. Intestinal cytokine response after gut ischemia: role of gut barrier failure. Ann. Surg. 1999; 229 (4): 478–486.

27. Austen W.G. Jr., Kobzik L., Carroll M.C., Hetchman H.B., Moore F.D. The role of complement and natural antibody in intestinal ischemia-reperfusion injury. Int. J. Immunopathol. Pharmacol. 2003; 16 (1): 1–8.

28. Khanna A., Rossman J.E., Fung H.L., Caty M.J. Intestinal and hemodynamic impairment following mesenteric ischemiareperfusion. J. Surg. Res. 2001; 99 (1): 114–117.

29. Therond P., Bonnefont-Rousselot D., David-Spraul A., Conti M., Legrand A. Biomarkers of oxidation stress: an analytical approach. Curr. Opin. Clin. Nutr. Metab. Care. 2000; 3 (5): 373–384.

30. Chernov V.N., Miziev I.A., Belik B.M. Prediction and prevention of acute ulcers and erosions of the stomach and duodenum in surgical patients. Vestnik khirurgii. 1999; 2: 12–15. (In Russian)

31. Kovalenko N.Ya., Matsiyevsky D.D., Arkhipenko Yu.V. Organspecific features of liver, kidney and brain blood supply in acute hemorrhage in rats with different resistance to circulatory hypoxia. Patologicheskaya fiziologiya i experimentalnaya terapiya. 2001; 2: 20–22. (In Russian)

32. Lektsii po gepatobiliarnoy khirurgii [Lectures on hepatobiliary surgery]. Ed. Gal’perin E.I., Dyuzheva T.G. Moscow: Vidar-M, 2011. 536 p.

33. Straub R.H., Wiest R., Strauch U.G., Harle P., Scholmerich J. The role of the sympathetic nervous system in intestinal inflammation. Gut. 2006; 55 (11): 1640–1649.

34. Xu J., Liu L. The role of calcium desensitization in vascular hyporeactivity and its regulation after hemorrhagic shock in the rat. Shock. 2005; 23 (6): 576–581.

35. Lund N., de Asla R.J., Cladis F., Papadakos P.J., Thorborg P.A. Dopexamine hydrochloride in septic shock: effects on oxygen delivery and oxygenation of gut, liver, and muscle. J. Trauma. 1995; 38 (5): 767–775.