Examination of Pathological and Biochemical Findings of the Damage Caused by Liver Retraction During Abdominal Surgeries Using an Experimental Model

Background: Our aim in this study is to answer whether hepatic retraction during abdominal surgery causes damage to the hepatic tissue. Materials and Methods: Thirty Sprague-Dawley rats were allocated to the following four groups: (1) Control group (2): Retraction group: Pressure was applied to the liver with Farabeuf’s retractor (3): Crush group: The liver was crushed with a bulldog clamp, and (4): Deviation group: The liver was deviated cranially as creating angling to vascular structures. A liver tissue sample was taken for pathological and biochemical examination. Blood samples were collected for ALT, AST and LDH measurements. Results: The crush group showed a significant elevation of serum ALT, AST and LDH levels, decreased tissue GSH levels, increased MDA levels, severe sinusoidal dilatation/congestion, and necroinflammatory focus in the postoperative histopathological findings. The deviation group showed elevation in serum ALT levels, sinusoidal dilatation/congestion and necroinflammatory focus postoperatively. According to the histopathological findings, although balloon cell degeneration, sinusoidal dilatation/ congestion and necroinflammatory focus were still seen on the 28 ^th day in the retraction, crush and deviation groups, the difference did not show statistical significance with the control group. Conclusions We found that the crush mechanism was more harmful to the liver tissue than the angling of vascular structures. We recommend keeping the hepatic retractions at minimum tension during the surgical procedures to protect the liver tissue, especially in patients with limited liver function such as cirrhotic cases and newborns with biliary atresia.