Successful modulation of portal inflow by somatostatin in a porcine model of small-for-size syndrome

BACKGROUND: Somatostatin may prevent the small-for-size syndrome in subjects undergoing extended hepatectomy by decreasing portal pressure. METHODS: Twenty pigs underwent 70% hepatectomy (H70 group, n = 7), 90% hepatectomy (H90 group, n = 7), or sham laparotomy (control group, n 5 6). Splanchnic hemodynamics was measured before and after an intraoperative infusion of somatostatin. RESULTS: The portal vein flow normalized to liver weight increased in both H70 and H90 groups (from 125 +/- 42 to 342 +/- 82 mL/min/100g, P = .031 and from 140 +/- 46 to 530 +/- 241, P = .016, respectively). The hepatic venous pressure gradient (HVPG) increased in the H90 group only (from 5.5 +/- 5.8 to 13 +/- 4.9 mm Hg, P = .004). Somatostatin decreased portal vein flow normalized to liver weight in both H70 and H90 groups (from 408 +/- 224 to 360 +/- 227 mL/min/100g, P = .031 and from 560 +/- 190 to 466 +/- 189 mL/min/100g, P = .016), and restored a normal HVPG in the H90 group (from 14.3 +/- 4.8 to 7.7 +/- 6.1 mm Hg, P = .047). CONCLUSIONS: Somatostatin restores a normal HVPG in the setting of small-for-size syndrome and can be considered as an effective pharmaceutical modality of portal inflow modulation after extended hepatectomy. (C) 2016 Elsevier Inc. All rights reserved.