Microcirculation changes during liver resection — A clinical study

• Sidestream dark-field imaging was successfully used to measure hepatic microcirculation.
• Hepatic resection leads to an increase of sinusoidal red blood cell velocity.
• Sidestream dark-field imaging could potentially be used to perioperatively identify histological damages.

BackgroundIn 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 methods40 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.ResultsAfter 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).ConclusionA hepatic resection leads to an increase of sinusoidal RBCV. SDF imaging could potentially be used to intraoperatively identify histological damages.