Open AccessSurgical correction of the chronic liver purulent-septic lesions
Author(s) -
O G Kotenko,
A.V. Gusev,
Oleksii Popov,
А В Гриненко,
Mikayel Grigoryan,
K. O. Yuzvuk,
Andrii Zhylenko
Publication year - 2019
Publication title -
sučasnì medičnì tehnologìï
Language(s) - English
Resource type - Journals
ISSN - 2072-9367
DOI - 10.34287/mmt.2(41).2019.18
Subject(s) - medicine , liver abscess , surgery , lesion , dissection (medical) , liver transplantation , abscess , antibiotics , transplantation , microbiology and biotechnology , biology
Purpose of the study. The purpose of the studyis to improve the results of surgical treatmentof patients with purulent-septic lesion of theliver substantiating the indication for resectionmethod use.Material and methods. The work is based on acomparative analysis of the results of examinationand treatment of 64 patients aged 10 to 81 yearsold, with chronic liver abscesses in the departmentof surgery and liver transplantation during the1995–2016 periods.According to the tasks of the study patients aredivided into two groups. In 30 (46,8%) patients(the study group), various types of anatomicalresection of the liver with a purulent lesionwere performed without its dissection duringthe operation; in 34 (53,2%) patients (groupof comparison) they performed the disclosure,sanation, drainage of purulent cavity. Themajority of patients with chronic liver abscessestreated the abscess with a puncture or drainagemethod under the control of ultrasound in othermedical institutions of Ukraine.Results. The results of diagnosis andtreatment of 64 patients for chronic liverabscesses from 1995 to 2016 are analyzed. In thestudy group, the patients performed anatomicalresection of the liver, in the comparison group –standard surgical interventions – the disclosureand drainage of the abscess of the liver. The durationof antibiotic therapy after surgery in the comparisongroup is significantly higher than in the study group,respectively, 22 ± 3,4 and 5,75 ± 1,6 days; p < 0,001.Second-line antibacterial drugs after drainingoperations were used more often (p < 0,001) thanafter resection interventions, respectively, in94,1 and 6,6% of cases. The duration of treatmentof patients in the hospital after surgery in thestudy group was less than in the comparison group,according to 15,1 ± 0,7 and 27,3 ± 3,05 days; total 25,9 ± 1,4 and 45,7 ± 3,45 days (p < 0,001).After drainage operations, drainages from theabdominal cavity were removed later than afterresection interventions, respectively, 17,1 ± 2,8and 6,35 ± 1,1 days (p < 0,001), through.Conclusion. Resection for chronic purulentsepticlesions of the liver is the priority methods ofsurgical treatment. The analysis of the obtainedresults allows us to conclude that resectiontechnologies contribute to the rapid normalizationof physical and social rehabilitation of patientswith septic liver damage.Keywords: liver abscess, liver resection,chronic, purulent-septic.