Various metabolites were measured in the blood leaving the partially heapatectomized (2/3) liver and the values were compared with the blood leaving the biopsies (<10% resection ) and inta live. The study)'as designed for having an idea of the role, which the given metabolites may have the regulation of liver regeneration or at least how is the organ affected by such surgicaltreatement drain for the hepatic veins. A sample thus could be drawn from the Vena Cava as anterior to the ligature, allowing access exclusively to hepatic venous blood.
Based on the above model, selected metabolites of clinical importance were analyzed in the study at various time intervals after 2/3rd hepatectomy and compared with changes Inafter taking a small biopsy ('l.-ess than 10% of the liver) and comparing these with in the intact (control).
The level of Glucose in the hepatic venous blood dropped below the controlhours in hepatectomized group and within 8 hours in Biopsy group and persisted at thislow leavel unlearn recovery by 168 hours (1 week). The decrease in glucose concentration was le Biopsy group as compared to partially hepatectomized group. In the partially hepatectomized group there is a transient increase in the levelof cholesterol which reaches the highest level at 36 hours followed by a decrease, which reaches the control level at week This. as accompanied by a near parallel and marked increase in the Low De Cholesterol (LDL-C) in the hepatectomized group by 36 hours while High Density Cholesteroi (HIDL-C) level dropped initially followed by a trend towards normalization by the end of 168 hours. In contrast in the Biopsy group there was no notewortt.1 change in the' e Throughout While the LDL-C dropped noticeably below the control level and differed substantial from the levels in partially hepatectomized group almost throughout the observation period of 1 week HDL-C varied inconsistently close to the normal level at most of the observation time in the Biopsy group except at 8 and 96 hours. Transient changes also occurred in the levels of triglycerides in the partially hepatectomized and Biopsy group. In both groups restoration to near control level occurred earlier in Biopsy groups.
Both Glutamate Pyruvate Transaminase (GPT) and Glutamate Oxaloacetat (GOT), showed early ,increase (8 hours) after both operations. GPT returned to near control level between 48-72 hours, while GOT regained normal level by 72 hours in both group. Noticeable increase in Alkaline Phosphates (AP) occurred only in the partially hepatectomized group with a delay between 24-96 hours before ultimate normalization. No significant char characterize the Biopsy group. Lactate Dehydrogenase (LDH) increased early in be groups. The elevation was sustained, though somewhat inconsistently in the biopsy g tended to normalize by 168 hours of surgery in the biopsy group whereas hepatectomized group there was a steady decline toward control level after the initial ea contrast to LDH, rGT showed little change in the partially hepatectomized group but in the biopsy group noticeable increase occurred in comparison with both the partially hepatectctomized and control groups. The change was somewhat sustained prior to ultimate recovery. Opposite effects were observed on serum CK in the two experimental groups. Creatine Kinase (CK) increased early (4 hours) in the partiaIl., hepatectomized group but decreased in the biopsy group at 16 hourscontrol1evel occurred in both groups at 48 hours onwards.
The total protein dropped below the control level by about 25% at 4 hors after partial hepatectomy. A comparatively less decrease in the biopsy group is also observed at 4 groups the Protein level tends to reach the normal level at 48-72 hours. The level of globulins in both groups decrease by about 40% at 4 hours and remain below normal throughout it both groups, although showing some increase at 16 and 48 hours in the partia1!y groups. A look at the level of Albumin shows that the Albumin rises by about 30% above normal during 48-72 hours. This indicates that the liver remnant synthesizes I releases 30% more albumin that normal raising the total protein level to its normal value. Thus the nearly normal level of total portieres at 72 hours is not due to lack of utilization of globulins by the liver but due to the 3 synthesis/release of Albumin. Similarly the 25% decrease in total protein during 72-96 hours seems the be due to the decrease in Albumin level.
Urea .and Creatinine levels showed a tendency to decrease as time after par progressed. Initially the urea level increased slightly and transiently during the first il hepatectomy. Thereafter a steady decline was evident. While the creatinine level decreased during the first 4 hours The level of both compounds remaining below normal even one week p " the biopsy group, the level of urea and creatinine fluctuated close to the normal level with ultimate recovery by the end of one week of surgery. The fact that urea and creatinine continued to decrease throughout the one week period after partial hepatectomy in the present study probably reflects a shied towards relatively greater synthesis of uric acid and its release in the hepatic blood as is reflected in it increasing levels postoperatively in the hepatectomized group.
Serum Bilirubin remained above normal during the initial 16 hours after partial hepatectomize and then declined to near normal level by the end of one week. Intriguingly, the change in the biopsy group was the exact opposite of the pattern for the Hepatectomy group point by point.
Serum iron showed slight increase over the normal level in the first 8 hours postoperatively in both, the partially hepatectomized and biopsy groups. The level returned to near normal at 16 hours onwards in the partially hepatectomized group but in the Biopsy group it remained above normal in general and increased markedly by 168 hours. The level of serum calcium and p unaffected by either of the two surgical treatments. Magnesium increased significant over and above the control level in the biopsy group while in the partially hepatectimized group barring a slight increase at 4 hours, the magnesium level merely fluctuated around the control level observation period.
The observations provide evidence of substantial disturbance in the metabolism of the level following both partial hepatectomy and Biopsy. Noticeable changes some times quiet significant were discernible in the levels of various metabolites studied, but the direction of change varied with individual metabolites leaving the liver in the hepatic venous outflow. Often the partial heplectom group and Biopsy group showed noticeable difference not only with respect to direction of change, but also in the timing of onset of change. In nearly all cases the variation in the levels of the metabolize were transient followed by restoration to near control values by one week.