Bacterial translocation after major hepatectomy in patients and rats
X. Wang, R. Andersson, V. Soltesz and S. Bengmark
Department of Surgery, Lund University, Sweden.
Bacterial infections are frequent complications after liver resection. Of
138 patients who underwent major hepatectomy, 11 patients (8%) developed
intra-abdominal sepsis in the postoperative period. Seven bacterial strains
of gut origin were isolated from the abdominal cavity. Eight patients had
multiple bacteria cultured. In the experimental studies on rat models,
positive mesenteric lymph node cultures were seen 2 hours after removal of
70% and 90% of the total weight of the rat liver, and 12 hours after 50%
hepatectomy, persisting for 3 and 4 days after 50% and 70% hepatectomy,
respectively. The incidences of bacteremia 2 and 4 hours after 90%
hepatectomy were 80% and 100%, respectively; 6 hours after 70% liver
resection, the incidence of bacteremia was 33%. Blood cultures were
positive in only 6% of the rats following 50% hepatectomy, and in none of
the controls. Thus, bacterial translocation occurs in the early course
after hepatectomy, the incidence being proportional to the amount of liver
tissue removed.
