Effects of Temporary Interruption of Hepatic Blood Circulation on the Liver, Brain, and Heart During Experimental Cholestasis

Large-scale liver surgeries often require the temporary interruption of hepatic blood circulation, a process that can lead to potentially irreversible damage to the liver and other organs. This study aims to investigate the histochemical, histological, and ultrastructural changes in the liver and other organs following temporary hepatic blood flow interruption. Experiments were conducted on 42 rats, randomly assigned to two groups: Group 1 (the animals of this group were subjected to only ligation of the hepatoduodenal ligament; 21 rats) and Group 2 (which underwent bile duct ligation; 21 rats). On Day 6, the hepatoduodenal ligament was interrupted. Decapitation was performed at specific time points following ligature removal: 15 minutes (n=7), 24 hours (n=7), and 48 hours (n=7). Tissue samples were collected for histochemical, histological, and electron microscopic analysis. The investigation revealed that damage to the liver and other organs after temporary hepatic blood flow interruption and subsequent restoration was more prolonged and severe in the presence of cholestasis than in its absence. In the case of underlying cholestasis after temporary disconnection of the liver from the blood circulation and its restoration at different times, the damaging changes in the liver, heart, and brain lasted longer and were more severe than without cholestasis. Changes in the liver were already visible in the immediate period after the restoration of blood circulation (15 minutes): new formation of bile ducts, or neoductulogenesis, was observed. At 24 and 48 hours, the number of "neoductus" decreased, possibly due to improved passage and drainage of congested bile through newly formed pathways and reduced pressure in the intrahepatic bile ducts. The organ-specific nature of injury is evident in that, under conditions of cholestasis, tissue damage develops earlier following the restoration of hepatic blood flow. In the early period after tourniquet removal, pronounced hepatic alterations are observed; although these changes partially regress over time, complete recovery is not achieved. Subsequently, the site of pathological processes shifts from the liver to other vital organs, including the central nervous system and the heart.