Prevention of Post-Resection Acute Liver Failure by Various Methods of Cyanocobalamin Administration in the Experiment

Anastasiya Yu. Laptiyova, Alexandr A. Andreev, Аlexandr А. Glukhov, Dmitry A. Atiakshin, Anton P. Ostroushko, Sergey N. Boyev, Tatyana G. Nikishina, Elena V. Mikulich, Pyotr I. Koshelev, Ekaterina A. Andreeva

International Journal of Biomedicine. 2020;10(3):257-261.
DOI: 10.21103/Article10(3)_OA11
Originally published September 10, 2020


Background: Surgical treatment of massive hepatic formations is an acute problem of operative hepatology, often being the only way to increase the life expectancy of patients. However, even nowadays, liver surgeries are considered to be traumatic, high-risk interventions due to the development of a potent body stress response induced by tissue damage, risk of severe intra- and postoperative complications, and high mortality. High mortality rates, especially after extensive liver resections, are more often associated with bleeding, bile flow from a liver section with the subsequent development of peritonitis, intoxication, and post-hepatectomy liver failure. The aim of this study was to perform intraoperative, post-resection prevention of acute liver failure (ALF) by applying cyanocobalamin in the experiment.
Methods and Results: The study included 96 sexually mature male Wistar rats, which were divided into 4 groups, 24 animals in each group. A conventional 70% hepatectomy was performed on animals of all groups. Prevention of post-hepatectomy liver failure (PHLF) was not performed in animals of the control group (CG) 1; animals of CG2 received 1 ml of 0.9% sodium chloride solution that was injected into the preserved hepatic lobes intraoperatively; animals of the experimental group (EG)1 received 10 intrahepatic injections of 0.1 ml of cyanocobalamin (200 μg/ml); animals of EG2 received 1ml of cyanocobalamin (200 μg/ml) intraperitoneally. The general condition of the animals (activity, appetite), healing time of the postoperative wound, and weight of the regenerated liver were assessed after the experiment. Biochemical methods included assessment of the indices of the cytolysis syndrome, cholestatic syndrome, the syndrome of hepatic cell failure, as well as the analysis of oxidative stress parameter and sevaluation of the expression of transforming growth factor beta ( TGF-β).
On Day 5 after hepatic resection, a significant improvement in the general condition of the animals (increased appetite and activity) was noted in EG1 and EG2. Intraoperative, intrahepatic administration of cyanocobalamin can increase the TGF-β expression by 2.5-3 times, affecting the proliferative activity of hepatocytes and providing recovery to 96.15±4.31% of the initial liver weight by Day 14 after hepatectomy
Conclusion: Intraoperative, intrahepatic administration of cyanocobalamin prevents the development of ALF in the early postoperative period and ensures restoration of the anatomical and functional integrity of the liver.

acute liver failure • intraoperative prevention • cyanocobalamin • hepatectomy
  1. Andreev AA, Ostroushko AP, Laptiyova AY, Gluhov AA. [Reparative hepatic regeneration after segmental resection (review article)]. Aspirantskij Vestnik Povolzh`ya. 2018; 5-6:  183-190. [Article in Russian].
  2. Rutkin IO, Popov SA, Moiseenko VE, Biketov MA, Timergalin IV, Granov DA. [Endovideosurgical resections of the liver: experience of “Russian scientific center of radiology and surgical technologies named after acad. A. M. Granov.” ] Vestn Khir Im I I Grek.. 2018; 177 (5): 47-52. [Article in Russian].
  3. Ermolaev PA, Khramyh TP, Barskaya LO. [Mechanisms of damage and compensation of the systemic hemodynamics after maximally permissible hepatic resection in rats]. Omskij Nauchnij Vestnik. 2015; 2 (144): 85-88. [Article in Russian].
  4. Ahmedov SM, Safarov BD, Rasulov NA, Tabarov ZV. [Extensive hepatic resection in complicated locally advanced liver cancer]. Annals of HPB Surgery. 2014; 19: 4: 26-31. [Article in Russian].
  5. Ahmetzyanov FSh, Idrisov MN. [Methods of hepatic resection]. Kazanskij Medicinskij Zhurnal. 2015;  96: 4: 563-567. [Article in Russian].
  6. Kotenko OG, Kondratyuk VA, Fedorov DA, Grinenko AV, Korshak AA, Gusev AV, Popov AO, Grigoryan MS. [Embolization of the portal vein branches in preparing patients for extensive liver resection]. Annals of HPB Surgery. 2014; 19: 4: 21-25. [Article in Russian].
  7. Bhat M, Pasini E, Baciu C, Angeli M, Humar A, Macparland S, et al. The basis of liver regeneration: A systems biology approach. Ann Hepatol. 2019;18(3):422-428. doi:10.1016/j.aohep.2018.07.003
  8. Khoronenko VE, Donskova YS, Baskakov DS, Drozhzhina OV, Sidorov DV, Lozhkin MV, et al. [Prophylaxis of hepatic insufficiency after major hepatic resections]. Anesteziologiya i Reanimatologiya. 2014; 4: 33-38. [Article in Russian].
  9. Higgins GM. Experimental pathology of the liver. I. Restoration of the liver of the white rat following partial surgical removal. Arch Pathol. 1931;12:186-202.

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Received July 14, 2020.
Accepted August 12, 2020.
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