Prevention of acute post-hepatectomy liver failure in patient with liver echinococcosis
https://doi.org/10.17238/2072-3180-2021-4-15-22
Abstract
Introduction. The development of surgical technologies in recent years makes it possible to translate the experience of treating patients with malignant neoplasms of the liver to the treatment of patients with benign liver damage.
Methods. Since 2018, in the surgical clinic of the Botkin Hospital, with liver echinococcosis and the need to perform extensive liver resections, the portoembolization technique has been used to develop vicarious hypertrophy of the remaining lobe of the liver. The analysis of the results of treatment of 64 patients who underwent a resection method of treatment was carried out. The main group included 13 patients who underwent 8 portoembolization procedures. The second group was represented by 51 patients who were operated without preliminary embolization of the right branch of the portal vein. The study evaluated the following indicators: duration of surgery, volume of blood loss, postoperative bed-day, complications according to the Clavien-Dindo classification, specific complications according to ISGLS, relapses during the first year after surgery.
Results. The immediate results of surgical treatment (the number of general surgical complications in the postoperative period and its duration) in patients after preoperative embolization of the right branch of the portal vein were significantly better than in patients operated on without taking into account the need to prevent the development of acute post-resection hepatic failure. Long-term survival results did not reveal significant differences.
Conclusion. Thus, modern surgical technologies that allow to achieve an increase in the volume of the functioning liver parenchyma can reduce the number and severity of postoperative complications and improve treatment results.
About the Authors
A. V. Shabunin
Botkin Hospital;
Russian Medical Academy of Postgraduate Study, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Corresponding Member of the Russian Academy of Sciences, Professor, Doctor of Medicine, Head of the surgery department; clinic chief
Russia, 125284, Moscow, 2-nd Botkinsky pr., 5
V. V. Bedin
Botkin Hospital;
Russian Medical Academy of Postgraduate Study, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Doctor of Medicine, associate professor surgery department; Chief of Surgical Department
Russia, 125284, Moscow, 2-nd Botkinsky pr., 5
M. M. Tavobilov
Botkin Hospital;
Russian Medical Academy of Postgraduate Study, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Doctor of Medicine, associate professor surgery department, head of the department of liver and pancreas surgery
Russia, 125284, Moscow, 2-nd Botkinsky pr., 5
A. A. Karpov
Botkin Hospital
Russian Federation
Russian Federation
Candidate of Medical Scienses., HPB surgeon, HPB department
Russia, 125284, Moscow, 2-nd Botkinsky pr., 5
S. S. Lebedev
Botkin Hospital;
Russian Medical Academy of Postgraduate Study, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Candidate of Medical Scienses., associate professor of Surgery Department; HPB surgeon, head of the department of ambulatory oncology
Russia, 125284, Moscow, 2-nd Botkinsky pr., 5
M. N. Aladin
Russian Medical Academy of Postgraduate Study, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
resident of Surgery Department
Russia, 125284, Moscow, 2-nd Botkinsky pr., 5
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Review
For citations:
Shabunin A.V., Bedin V.V., Tavobilov M.M., Karpov A.A., Lebedev S.S., Aladin M.N. Prevention of acute post-hepatectomy liver failure in patient with liver echinococcosis. Moscow Surgical Journal. 2021;(4):15-22. (In Russ.) https://doi.org/10.17238/2072-3180-2021-4-15-22
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