Abstract:Objective: To create the animal model of associating liver partition and portal vein ligation (PVL) for staged hepatectomy (ALPPS) in rats. Methods: Sixty healthy male SD rats were equally randomized into PVL group, ALPPS group and sham group. Rats in PVL group underwent ligation of the portal vein branches for the left lateral, left middle, and right lobes of the liver and complete caudate lobe resection, with preservation of the branches for the right middle lobe; rats in ALPPS group underwent the same procedures as those of PVL group combined with parenchyma splitting of the middle lobe of the liver along the ischemic boundary; rats in sham group underwent dissociation of the portal veins without ligation. The postoperative hepatic regeneration rate (HRR) and liver function were determined, and the pathological changes in the left middle lobe of the liver and Ki-67 expression in the right middle lobe of the liver were examined. Results: Compared with sham group, the HRR of the right middle lobe in both ALPPS group and PVL group were significantly higher than that in sham group at any postoperative time point (all P<0.05), and the HRR of the right middle lobe in ALPPS group was significantly higher than that in PVL group on postoperative day (POD) 4 and 7 (155.96% vs. 118.15%; 174.86% vs. 133.55%, both P<0.05). The liver function parameters in PVL group were better than those in ALPPS group at early postoperative stage (all P<0.05), but showed no significant difference in late postoperative stage between the two groups (all P>0.05). Results of histopathological examinations showed that the focal necrosis in the left middle lobe of the liver was more intense in ALPPS group than that in PVL group on POD 1 (P<0.05), and the Ki-67 positive index in the tissue of the right middle lobe in ALPPS group was significantly higher than that in PVL group on POD 2 and 4 (85.36% vs. 61.84%; 43.40% vs. 29.06%, both P<0.05). Conclusion: Both ALPPS and PVL can promote hepatic regeneration, but ALPPS is faster than PVL in promoting hepatic regeneration. A rat model of ALPPS has been successfully established, which may provide a basis for further investigation on the mechanism of ALPPS induced liver regeneration and ALPPS-associated complications.