Open Access"Big trifles" of advanced liver resections for alveococcosis
Author(s) -
В. Е. Загайнов,
N. Kiselev,
В. А. Бельский,
П. И. Рыхтик,
Nikolai Bobrov
Publication year - 2019
Publication title -
annaly hirurgičeskoj gepatologii
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.138
H-Index - 1
eISSN - 2408-9524
pISSN - 1995-5464
DOI - 10.16931/1995-5464.2018433-44
Subject(s) - medicine , liver transplantation , surgery , efferent , lesion , transplantation , afferent
Aim. Analysis of the techniques of advanced liver resections involving transplantation technologies which affect the results of surgery for advanced liver alveococcosis. Material and methods . There were 65 patients with massive complicated liver alveococcosis for the period from 2008 to 2018. Radical procedures were applied in 82% of cases (n = 53). Mechanical jaundice was observed in 45% of patients, portal hypertension — in 25%. Previous palliative surgery was applied in 58% of patients. Thirty-three patients (50.8%) had advanced parasitic lesion with involvement of afferent and (or) efferent vascular structures. Distant metastases were detected in 6 patients: metastatic lung lesions occurred in 5 of them, simultaneous injury of brain and lungs — in 1 case. Results. There were 47 RO-resections with application of transplantation technologies including 4 extracorporeal resections and 6 orthotropic liver transplantations. Reconstruction of great afferent and efferent vascular structures was performed in 47% of cases: IVC repair — 25 cases, PV repair — 25 cases. Resection of extrahepatic bile ducts was made in 33 cases. Postoperative complications occurred in 26 cases: Clavien-Dindo type II — 5, IIIb — 13, IVb — 2, V — 6. Bile leakage ISGLS class B occurred in 6 cases, class C — in 11 cases. Conclusion . Transplantation technologies for advanced liver resections and liver or its segment transplantation allow to achieve radical surgery in 82% of patients. Advanced operations are indicated for advanced liver alveococcosis due to good outcomes. There are various technical aspects of such operations which are useful to avoid most of complications.