The impact of hepatic steatosis on liver regeneration after partial hepatectomy

Background & Aim Experimental studies in animals have suggested that liver regeneration is impaired in steatotic livers. However, few studies have focused on the impact of steatosis in patients undergoing partial hepatectomy (PH). This study aims to determine the role of steatosis on liver regeneration in humans following PH. Methods Eighty-eight patients undergoing PH were included in this study. All patients underwent CT-scanning of the liver preoperatively and 7days after surgery. Additional CT-scans were performed 6months post-operatively. Preoperative and post-operative volumes of the total liver (TLV), future liver remnant (FLR) and liver remnant (LR) were measured on CT-scans. Regeneration indices (RI) were calculated at 7days and 6months using the formula: (Volume LRVolume FLR)/Volume FLRx100%. Based on histological examination of the resected part of the liver, patients were classified into three groups: (1) no steatosis, (2) mild steatosis (129%) and (3) moderate-to-severe steatosis (30%). Results The early RI (at day 7) was 40%, 24% and 20% for patients in group 1, 2 and 3 respectively. Late RI (at 6months) was 81% for group 1, 44% for group 2 and 22% for group 3 (P=0.019). At 7days, the LR represented 79%, 80% and 79% of the TLV for groups 13. At 6months, this was 93%, 92% and 79% respectively. Conclusion Although early RI after PH did not differ in patients with or without steatosis, the late RI in patients with moderate-to-severe steatosis was lower, suggesting that late liver regeneration is impaired in these patients.